Sam Campbell
Moh’D Ibrahim
Johnson City, Tennessee, United States

My wife is in Texas, threatening to file divorce papers. I am here, 996 miles away, trying to find Mrs. Smith who has wandered out of her room searching the entire hospital for her dead husband. When I find her on the fourth floor, she asks if I have seen Daniel. She has been with us for over a month after her daughter found her lying unresponsive on the floor. I guide her to the elevator and chat about the progress she is making in her recovery from the stroke, but she does not want to talk about that. She just wants her husband, and that is something I can understand because it is not her hand I wish I was holding right now. So I sit and let her talk about Daniel and I talk to her about Nadia until the bleeping of my pager calls me out of the conversation. It is a familiar interruption.

On my way to the emergency department, I think of Nadia and our life before moving to the States. We had been happy together, though it took years to convince her family to allow us to marry. Now, after three years of marriage, she wanted to end the life we had built together. After leaving our home, toiling in the university kitchen twelve hours a day, and barely making enough money to survive, she now feels I have abandoned her. The explanations I offer about my busy schedule fall short; I wonder at what point “busy” becomes just an excuse used to justify choosing work over my personal life.

In emergency department room 8, Nadia disappears from my thoughts. Mrs. White, a middle-aged artist, is gasping for air and clutching her chest. Her husband bends over her, wanting to help but not knowing how, while her toddler jogs around the room, oblivious to his mother’s illness. I watch the monitor as she explains that every few months she has spells of rapid heart rate. I nod as I listen to her, the same way I do when Nadia complains that I do not check on her often enough. She has atrial fibrillation, a cardiac arrhythmia that needs immediate treatment. I give her a drug to slow her heart rate and contact a cardiologist for a possible cardioversion.

With the situation under control, I head to the office to type up some notes. On my way, I step into Mr. Freedy’s room to check on him; he had been admitted for an exacerbation of heart failure. He is one of my favorite patients, a 95-year-old retired surgeon with a story for every occasion. I felt like I could use one of his stories now, perhaps the one about how he saved dozens of women who were massively bleeding or about how the babies he helped deliver grew up to become physicians and lawyers. Before I can ask for a story, I hear the burbling of his breathing and know there is extra fluid is in his lungs. I give him medicine to remove it, and he is smiling as I leave the room. I try to picture myself in old age; I cannot envision the scene without Nadia. I picture us sitting at the kitchen table, lasagna piled on plates, talking with each other. My pager interrupts my thoughts again.

I rush back to the emergency department, room 12. An unconscious man with a breathing tube is alone, motionless except for the rise and fall of his chest. A nurse appears beside me and says they found traces of amphetamines in his urine. He had been found lying in the street. I have him transported to the Intensive Care Unit and head downstairs for lunch.

Grabbing a sandwich, I retreat to my office and start typing up notes about my patients. I take a bite and the wheat tastes like cardboard, moistened by wet tuna and mayonnaise. My fingers slow their typing and I stare at the screen, trying to remember what Nadia had requested when she called two days ago. I rub the tired out of my eyes and laugh at myself. Doctors are the first to preach eight hours even when we barely get four or five ourselves. I remember Nadia’s request; she needed me to call the airport because she lost her suitcase during her last trip home. The distance is harder than we anticipated as she finishes school in Texas and I do my residency in Tennessee. I pick up my cellphone and consider calling her; it has been days since we last spoke, and that conversation ended in an argument. She had purchased a plane ticket from a fraud website to visit her family. I chastised her for the mistake, not sure how she could have been so careless, and hurt that she could find time to see them when she could not come spend a weekend with her husband. She mentioned divorce again during that call, and I knew her family was in the background, pushing her to leave everything and return home.

I begin dialing her number, but a colleague steps into the room and hands me a file. He is on the vascular surgery team I consulted concerning Mr. Wright, a middle-aged man admitted the night before with a numbness in his left leg. He had been diagnosed with diabetes, but had not followed up with a physician because he lost his insurance. My eyes scanned the information in the file. With such a neglected condition, many problems are possible, including loss of vision, strokes, and kidney failure. I made my way down the corridor toward Mr. Wright’s room. My cell phone buzzed in my pocket and I checked it before walking in, hoping that it was Nadia. Instead, I found a message from my mother: When are you going to make me a grandmother? With a frustrated sigh, I shove the phone back into my pocket and walked into Mr. Wright’s room. Delivering bad news to him would be easier than telling my mother that the only thing my wife planned to deliver soon were divorce papers.

The grown man cries when I tell him they might have to amputate his leg. The tears are large, bulbous droplets that stream down his face leaving trails of dampness in their wake. His whole body heaves and convulses and he sputters out words about the strength that was lost from the past and hope that is lost for the future. I feel my throat contract and burn with the need to allow myself to do the same, but I hold it in, swallow it down and offer up words of encouragement and reassurance. They sound weak even to me and I leave him to his sorrow.

I retreat to the restroom, the only place in the whole damn hospital a person can go to for moment of peace. I slip into the stall in the back and sit down on the toilet, then lean forward resting my head in my hands. My throat still burned with a need to cry or scream, but in the cool quiet of the second floor bathroom, all possibility of noise seemed out of place. So I sat there, thinking about how last month after Nadia’s first serious mention of separation I drove seventeen hours just to spend the night with her. But one night together was not long enough to erase dozens of nights spent apart. When the long distance first began I remember waking up in the middle of the night and searching for her in my tangle of sheets and blankets. When I could not find her I would wake up and could not fall back asleep. I tried to remember when I stopped reaching for her. I was fooling myself to think that she still stayed up, sleepless, missing me, even though she had never come to visit. The pain boils into anger and I ball my hands into fists and feel the urge to punch something. I hold it in, knowing that would not solve anything. Nothing helps, and the frustration turns to hopelessness.

The pager beeps and I am beckoned to Ms. Donovani’s room. She is an undergraduate student admitted earlier after a suicide attempt. Dumped by her boyfriend, she ingested two bottles of gabapentin to end her life. She is refusing medication and insisting that we leave her to die; the lonely world is too much for her. The floor of her room is sprinkled with dampened tissues. I do not know what I am supposed to do so I sit down and I cry too. She hands me a tissue and we share broken-heart stories. I say the words that I have been trying not to acknowledge.

“My wife wants a divorce.”

To my surprise, she starts to comfort me. I somehow convince her to take her medications. I somehow change her mind about giving up. When I leave her, she is no longer crying. I have saved her life, but on the drive home, I wonder how I can save my own.