Muscle Memory (for Alex Pretti)

The ICU nurse doesn’t look at the chart when she talks. “GCS four. Intubated, on propofol and fentanyl. No seizure activity overnight. Pupils sluggish but equal. Pressors stable.”

I glance back at the screen. “Oh,” I say, pointing. “And today’s her birthday, right?”

The nurse smiles. “Honey,” she says gently, “that’s what we put in the system for crash patients who come in alone. Until we know who they are, today has to be enough.”

My cheeks flush. Silly, naive. I step closer to the bed and begin the ritual I have burned into my hands as a second-year medical student.

I lift her eyelids and shine the light, checking pupils for size and symmetry. I drip cold water into her ear and watch for a blink. I call her “Ma’am,” because I don’t know what name to use. I can’t ask her the month of the year or if she knows why she’s in the hospital. I can’t ask her anything at all.

I pinch for pain. Trapezius, nail bed. My hands are sweating, and I’m nauseous at the thought of hurting her more. I push her suction catheter deep through the endotracheal tube, watching for a gag, a cough, some sign that the brainstem can still respond. In the end, all I’m able to elicit is a disconnected knee jerk reflex.

Around me, the nurses continue moving seamlessly, passing syringes, voices low and steady. Someone tucks the blanket back under the patient’s feet, another adjusts the drip. Watching them, I think about how years of training have taught nurses to step closer to suffering when others may step back. They choose compassion again and again, even when it costs them.

The nurse nods at her, softly, “Okay, sweetheart,” without waiting for a reply. As if the possibility of presence is enough.

The monitor hums. The room exhales.

Shreya S. Tamma
Houston, Texas