Tonight we are thinking about zinc protoporphyrin.
Dmitri flattens the brown napkin from our take-out tacos on the knee of his blue scrubs. He takes a ballpoint from his chest pocket and scratches the notation C34H32N4O4Zn into the frail tissue. As he writes, I watch fallow furrows form between his heavy eyebrows. “The important bit is the protoporphyrin. That doesn’t change.” His speaking voice is quiet and low. “The zinc changes. The ferrous ion changes.”
“That could mean anything,” I prompt.
He taps the ballpoint on his hastily linked Z and N, like a child’s abandoned bike and the lamppost it’s chained to. “Could,” he says.
“Cancer or an iron deficiency or, like, lead poisoning. You eat any paint prior to 1978?”
“Not that I recall. Was it really that recently they stopped leading paint?”
“Yeah. Shit’s crazy.”
He sighs and leans his head back against the brick wall of Azteca Mexican. The window glistens with alternating green and red neon over our shoulders. Dmitri closes his eyes. In the greasy chiaroscuro, the furrow returns, or perhaps never left, intensifies. “Shit’s crazy,” he mutters.
We don’t come back to protoporphyrin. Our think-tanks often go this way—one or the other of us presents a broad stroke, and we fill it in independently throughout the day. Sometimes we don’t reconvene with the details for weeks. Once, when we were trying to solve the issue of where to place the futon in his studio apartment, we dropped it for three months. Problem: I needed a place to crash. A solution eventually worked itself out. We were drunk off our asses on white wine spritzers, sobered up with the concrete of his balcony peppered into our cheeks. “It doesn’t belong in the house,” he said. “That’s why we can’t figure it out. It’s not that there’s no solution, it’s that the solution doesn’t involve the fucking futon, and we keep trying to solve around the futon.”
“What do we solve around then?” I asked.
The sun was rising over Brooklyn, over the Carroll Street Station somewhere, the green glassy windows glittering with dawn.
“Us,” he said. Since then we lie together, on his shag rug, though I still pay rent on my shared place in Manhattan.
When we polish off our tacos, Dmitri balls up our foils and used napkins, along with his note-taking napkin, and throws them all into the take-out bag sitting between us on the bench, and then he balls that up, too. I pitch it next to me into the trash. An overhand dunk is three actions when broken down into its chemical essentials: the wind-up, the muscle upward, and the flick of the follow-through. Our trash wheels around the rim of the waste bin like a quarter in one of those plastic wishing wells for sick children at the mall. When I lived in the Midwest, those things were everywhere. I haven’t seen one since moving to New York.
I look over my shoulder, still frozen at the end of my toss. “We should set one of those up for you,” I say.
For the first time, I don’t think he grasps what I’m referencing.
* * *
Dmitri has not produced his own oxygenated blood supply since 1307. This is our immense mystery, ours together. His diagnosis: vampirism.
We are three years into our respective programs. Dmitri, quite fittingly, in phlebotomy, and myself in radiology. We were placed in the same hospital last year for our internships, Brookdale University Hospital, and take the G and then the 3 train into work each afternoon for the graveyard shift. We’re surrounded in the rolled metal shell of the MTA by people just like us, tired in patterned or plain scrubs and comfortable sneakers. People who probably also intern at Brookdale, on different floors and in different departments. But I have never paid attention to these people once we’re on the subway platforms, periscoping up toward the surface through the tills and up the scabby stairways.
I can no longer recall a time in my life when I didn’t feel inextricably woven up in the patterns of the world. I see the numbers on the walls and slot them into the larger equations. It was like that when Dmitri and I met in Molecular Genetics. We were all of a sudden infrayable.
Tonight, I help Doctor Shalini with Ava Rodney. Ava Rodney plays volleyball with a local all-girl’s high school, and we’ve seen her three times already this year. She comes in close to midnight wearing a pair of black iridescent bike shorts and an oversized sweatshirt with AVIE BABIE printed on the back. We maneuver around her fussy mom to get Ava into the weighted vest and settled on the table so we can operate the machine. Then we leave them in a different room so we can diagnose the developed film.
Shal slaps a film onto the lightbox viewer. A woman’s fractured left femur shines on the bluish paper. A barely discernable filament in the bone, like a wire suspended in a bulb. We examine the film and pretend our expectations haven’t been predictably illuminated, pretend the radiograph has confessed something new.
She puts her hands on her hips. “How’s Creepy?” she asks. This is what everyone in the radiology department calls Dmitri. He’s known here for occasionally sprinting into the wait lobby and telling the intake nurse, Paula, to relay some sort of cipher on scrap paper to intern Ash Doppler. “This is of eternal significance,” he’d say. “Make sure to tell him that.”
“You know he hates it when you call him names,” I say. “Dmitri’s okay. We’re fine.”
“Uh-huh. You say that like it’s not true.”
“We really are.” I wouldn’t know how to describe in shorthand or medical terms what’s really on my mind. I stare into the fracture captured on the radiograph film, pressed fatally into the emulsion-gelatin. What happens is the silver chloride destroys itself, ions detach and reconnect, the gelatin reacts, we get the image. That’s what I’m really here for. But something exists in the rendering of the gap between two halves of the whole bone. I don’t have a name for it. “We’re not even looking at the real thing,” I say. “It’s like a painting.”
Shal rolls her eyes. “Sure,” she says, removing the film from the viewer. She flips a switch, and the lightbox flickers out. “A painting of super-dangerous rays and ions and stuff. You sure your head’s on straight, Ash? Need to take a nap in the supply closet?”
“Maybe later.”
“I’ll ask again in an hour.” She winks. We trace the hallways back to Ava’s examination room to deliver the news. She’ll have to stay off the leg for several weeks. No more volleyball. We make her an appointment to get casted.
“Can’t you do anything?” her mom stresses, and Shal and I exchange a glance. When mom and Ava shuffle off to outpatient, Shal breaks her serious spell.
“Sometimes, I wanna be a smartass when people say that. Like, I diagnose. I did my job. It’s their job to figure out the rest. Literally.”
I give my input, though she didn’t ask, “Non-professional opinion: resting is the most difficult thing to do.”
“Professional opinion,” she supplements, tapping her temple with a glossy nail. Her crows-feet are pretty and proper where they scrunch together at the edges of her eyes, smiling. “It is the most difficult thing. That’s why it’s not my responsibility. And it shouldn’t be yours, either.” But rest—sleep, specifically and in general—won’t factor into my ten-year development plan. I’m hopeful.
* * *
Dmitri leaves a note with Paula. BMB UGH. She hands it to me when I’m off the clock, pulling my sleeves through my light fall jacket, almost out the door. “Is this of eternal importance, too?” she asks. I flip the note the right way around to check.
“I think so,” I say.
“Who’s going for the bone marrow biopsy?”
“Dmitri.”
“Is everything alright?”
“Should be. It’s just standard.”
“Sure. Standard BMB. Goodnight, Ashford. Or morning, I guess. See you tomorrow.”
“See you.”
Average people don’t require regular bone marrow biopsies, but I understand Dmitri’s urgency.
The equation we are foxholed with now is an extension of the futon equation, wherein we’ve added to the principal outcome (us) the inevitable mortality of myself. Eventually, Dmitri will have plenty of room for a futon but even less reason for one. Eventually, I will die. My lifespan is an eighth of his current duration. It is a sliver in a pie chart, like when diagrams show how long humans have been on the earth in impossible-to-bear speculative ratios, or like a fracture in the bone.
We have counted on every possibility. How do you bottle the eternal? How do you wield it with a series of integers and facts? His condition does not transmit by sex or blood or grafting. I would not know how to culture it. We’ve experimented with ingestion, the root of every cultural myth. We’re running out of makeshift notepads as fast as we’re running out of time.
“What if there’s no way to turn you?” Dmitri suggested this last week, before sending off the HFE test. “Maybe I can be cured. That’s the inverse. We solve for that.”
“Not for forever, but for now?”
“It seems a little less reactive.” He gave me a small, reassuring smile. “A little more stable. One life together. We can handle that.”
* * *
Bone marrow biopsies aren’t my floor. They’re Dmitri’s, sometimes, and sometimes they’re performed in the cancer or outpatient rooms. Since the procedure only requires a certain sterile needle, I know Dmitri wants to get it over with in the apartment. He’ll have stolen the needle. When I throw my work bag into the kitchen, I see it sleeping in its peel-apart plastic bag on the counter next to the fridge. As long as my forearm. Conspicuous.
The second thing I see is Dmitri, standing on our confiscated stepstool, retrieving our Grey Goose from the top of the fridge. I make a show of readying myself to catch him, open-armed, bow-legged, stance wide as Nebraska. He grins over my head.
“Call and response,” he says. “I like those words. Built-in answers. You know, I used to go to church. This was back during the Avignon Papacy, so things might’ve changed.”
“Doubt it.”
“Good response,” he laughs, and falls forward into my arms. I almost don’t catch him, a few moments far from my initial preparations. Apparently, a few moments are already too many when it comes to readiness. He laughs, says, “Good call.”
We move to the living room. Dmitri holds the bottle by its neck in one hand, leaping out of his scrubs with help from the other. He poses. His brave face centered like the calm in a private pool. Voila. He stands like the Vitruvian Man, holds long enough for me to see, and doubles over laughing. Now his joy forms a question—the question—will you take advantage of my vulnerability? And I do. I kiss him flat on his back. Vodka ripples and simmers under his naked shoulder blades, into the valleyed floorboards, and I’m fighting crackpot tears as I let him sip what’s spilled off my soaked fingers. Sharp draw of bone on flesh. Soft sucking in, the convex touch of cheeks from inside, rare and beautiful. I take my fingers away. Kiss his chin once more.
He says, “Ashford.”
“Yes,” I say. This might signal the beginning of our new life—never ending or truncated. Either way, eureka is most exciting the very moment before the word flies off the genius tongue. When your potentially world-shaking greatness still waits behind the teeth, comprises an amoral feeling of about-to-be.
“Get the needle.”
“Yes.”
We work efficiently. He lays across the high countertop. Takes a swig of Grey Goose. “Go ahead with it, then,” he says. I scrub in at the kitchen sink. Our broken garbage disposal gulps my soapy wash-off down into its satisfied yawn. I take the needle, peel back the plastic sheath like I’m preparing a band-aid.
A bone marrow biopsy needle is hollow, a straightaway hadron collider, one of the few needles you’re supposed to use twice. I insert once to aspirate, the soft spot of the waistline directly above the right buttock. The skin plunges down at first with the needle’s tip, sheering through muscle into hard bone, then rebounds.
I often get caught finagling meaning from minutiae, small images, impressing the world deep into the folds of my brain—I don’t know what I’ll eventually have to contain or remember. A year or fifty or a millennium. So I become a ceaseless TCA cycle, acquiring energy and never respiring. I’m a sentimentalist. Yes, I love minutiae, the little stuff. Transversely, I love the soft contours of the large stuff just as much. Sometimes more. I want to lean forward and pinch the curve of Dmitri’s left cheek between my teeth where it meets the top of his thigh in a knit of sinew and muscle, I want to slide up from there and drop the BMB altogether and use my hands like wedges to mitosis his body apart. I feel bloodthirsty and fresh.
Dmitri slams the heel of his hand into the edge of the counter.
“Focus, Ash,” he demands. “You’re thinking of my ass.”
I am. The ass’s appeal factors very little into BMBs outside of our situation.
I remove the needle, then submerge a second time, deeper, for the painful part. Drawing out the sensitive splinters of bone with five slow circles of the syringe. I’m stirring the cauldron of his impossible body. Then it’s over, and he pulls on a pair of boxers and kisses me hard on the mouth. “Done like a real doctor,” he tells me. “Just a little sore. I’ll grant you permission to feel, provided you ask first.”
“Maybe later.” I’m too eager for what comes next.
We remove the samples to our bathroom counter. He rearranges it into what we’ve deemed a worthy enough lab—bringing the plank of cedar from behind the door, laying it over the open navel of sink basin, relocating the microscope from under the sink to the top of the plank. That microscope holds first place for most expensive uninsured item in this studio. We spent more money on it than I spent on my first semester of undergrad. For a stool, he brings one in from the kitchen bar, and I sit spread-eagle on the toilet lid, elbow up on the tank.
I admire his lean fingers transferring his own liquid marrow to an incandescent, sterile chip of slide. Engineered perfection, silica and boric oxide, the astonished B and O hooked together at low heat to create this impossibly frail square. Dmitri’s substance slowly adheres to the surface and swallows it.
I lean in. Push my cheek against his shoulder. As he places his eye flush with the ocular lens, his ribs hold his last inhalation steady in the belly. All those unused molecules perched upon his branching bronchioles. We wait. For the answer. For another piece to the puzzle. For hope, one more line to drop down below our magic equation.
“Shit,” he says, and rocks back onto his stool. The expression that comes into his face is mutation of his thoughtful look, but undeniably sad. “Want to confirm my observation?” he asks, and I lean forward and take the rubber viewing window over my dominant eye. I don’t have to. I already know. I taste it in his posture and the unspooling heat of his exhalations. Vampirism cannot be cured, because what vampirism is is cellular deformation, is eternal, non-fatal sickness of time. It’s bone marrow cancer.
* * *
We talk around it. Carcinoma. Leukemia. Permanent for now, an infirm tunnel into eternity’s vein. Unknowable, I wouldn’t know how to culture it, nor did I plan to in my lifetime. I wasn’t one of those students who gassed themselves up, wrote statements of intent with unfulfillable promises to big-name foundations, walked 5K’s in honor of colored ribbons folded at the heart. Nor did it ever occur to me I’d have to contract it in order to live. Contract. The wet muscles of the eye tightening around a single spot in the far-distance.
Carcinoma. Leukemia. The words float in the surface of every body of water—accumulating near the webbing of my toes in the shower, a lacuna in my coffee, the half-circle of saliva left on my wrist where he kisses it in the afternoon, when we wake up, face what’s left of the day. It’s raining. Fat drops of murky rainwater pelt the windows. New York City, obfuscated by liquid buckshot and a smog that rises off the Hudson River and comes, somehow, this far.
At night, on our shared floor, his arms cradling my wingspan, I think. I put together a formula, endow it with my pained desire for more of whatever this is, like God kissing the first man to make him breathe. I tried to trace the roots of this sickness catching up with us. Looking for signposts I didn’t have the foresight to recognize then.
No signs of a terminal route in the innocent beginning. The first words he ever said to me: “Ashford? Is that a real name?”
The first I said to him, as I unpacked my things and laid them in a cascading row on the blacktop desk while he intently eyed the organization, the exacting geometry: “Yes, in that it’s historical. No, in that it’s made-up, like all names. Like yours. Dmitri? Are you a vampire or something?”
He said, “Yes.”
I smiled. We were always in on the joke together, I think. We always knew we’d have to fight hard to keep it funny. “I like it. Let me see your fangs.”
He pulled on his upper lip with the bit-down stub of nail on his pinky. “None,” he mumbled, letting the lip snap wetly back into place. “It’s quite difficult to live. It’s difficult to get the dietary supplements I need. I’m hoping to pick up a few tricks.”
“Come to my place after class. I’ll show you some.”
He raised his dark eyebrows. “Okay. But only if I can show you a few of mine.”
I liked him immediately. We made out underneath the sheets of my bunkbed, dormitory-standard pine creaking at the slightest touch. His ribs were nice and cool under my fingertips. I’ve always been a nervous perspirater. I kept the window propped open with a hardcover copy of Blindness. When my roommate came in between classes to switch out his books, we held still, listening for the door to squeal shut, waiting several seconds after it finally did. His palm lingered on my forearm.
“I like to ask permission first,” he whispered.
I gave it. “As long as you’re okay with, you know. I’ll be candid. I haven’t fully transitioned yet.”
“Ashford.” He laughed. I’d misunderstood. We had sex, he took my blood. Positive ions, positive feedback loops. The cycle perpetuates itself.
* * *
We cook breakfast—Dmitri scrambles the eggs and I smack pancakes with a plastic spatula until both sides are evenly brown—and settle in at the dining table. He skims our tabletop copy of The Brothers Karamazov, reading paragraphs as they stand out to him on the pages.
“Why do you love me?” I ask. He pauses with his thumb lifting the corner of the next page.
“Your ferrous ions. You possess an abundance of scarce resources. Scarce to me, anyway,” he says. An answer that feels canned, as if he’d had it prepared and waiting in a hip-level holster.
“Not joking.”
“Hard to quantify. Maybe impossible. I just love you, Ash. You’re my missing one. Solve for X. That’s you. Every time. You’ve asked an unfair question. Why do you love me?”
“Hard to quantify,” I say.
His upper lip twitches into a smile. “See?”
“But not impossible.”
“Optimistic.”
“Realistic.”
“This is why I love you.”
“So not impossible,” I say. “There.”
“I never said impossible.” He closed the book and fixed his face on mine. Two moons, coming into close, bright orbit. “I just said maybe.”
* * *
We’re asking the wrong questions. Theoretical or practical, equations only lack for solutions if you’re viewing them from failed perspectives. You may believe you’re the guy tossing change into the well, only you may actually be the guy cupping his hands at the bottom, or a scale of moss on the middlemost brick, or you’re the copper in the penny, or maybe it’s not a penny, but a quarter or a dime or a Sacagawea dollar. So the first problem to solve is where you stand or fall from, then you can solve for the outcome of gravity, and once you know the outcome and rules of gravity, you spool it back up, reverse, counteract, cure.
“You’re talking magnets,” says Dmitri, across from me on our sleeping rug. He holds his hands out as if around a rubber ball. “Or extreme g-force. Like that trick planes do where they fly up then straight back down at high speeds to simulate space.”
“No. Smaller. I’m talking drilling a hole through the coin and yanking it back up on a string.”
“A trick wish?”
“It works with vending machines.”
“Wishing wells don’t engage mechanically like a chip or soda dispenser in an old break room, Ash. Neither do all immune systems.”
“Forget the wishing well.”
“Forgotten.”
“How do we make your body think it’s mine? Or reverse. What size coin, what size slot, what string?”
“Are you suggesting lymph or hormone transfusion? Possibly a protein code, one that fills the gap. If there is a gap. If we could get that closed up.”
“Either might have the same effect. All might be best.”
He opens his hands around the sides of my face, pulling my clammy forehead down to touch his cool one. His eyes are open, awake with light. This is how I know him best. I like the passage of time and questioning, but I recognize the destination. Discovery. “You are everything,” he says. Then he closes his eyes. I recognize that, too. “Don’t ever give up.”
“I’ll never give up on you.”
Are we fooling ourselves?
I’m young still, you know. I can’t be afraid of the negative outcomes I predict, the ones I jot down frantically in the margins of notebooks, or across the tops of my knuckles in permanent black marker. Up and down the skin of my arms—illegible notations for an eternity I must believe in.
We haven’t asked the question aloud yet, the most obvious, the one we’ll always fail to solve: what if this isn’t forever? I won’t ever give up. It’s like boarding the G line in the morning, stuck in the tube with all these tired and frail people, but you can’t linger. You have to get to where you meant to go and disembark, periscope into the city, see the life you have to live. I have to go to work at night and come home in the morning and face this love I chose.
There’s at least one problem that lives forever. Sometimes, my missing one, we solve for X and get a recurring decimal. Sheer luck, and what now? There is no end.