Authors: John Hornor Jacobs
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Designed by Renata Di Biase
Library of Congress Cataloging-in-Publication Data
Jacobs, John Hornor.
This dark earth / John Hornor Jacobs.—1st Gallery Books trade paperback ed.
p. cm.
I. Title.
PS3610.A356434T45 2012
813'.6—dc23
2011050655
ISBN 978-1-4516-6666-3
ISBN 978-1-4516-6667-0 (eBook)
For my whole fam-damily,
especially Kendall, Lily, Helen, and Cookie
Chapter 2: Everything that Rises Must Converge
Chapter 4: As Fierce as the Grave
Chapter 5: The Beauracracy of the Dead
The race of man, while sheep in credulity, are wolves for conformity.
—Carl van Doren
I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones.
—Albert Einstein
It was a family, once, Lucy saw. And maybe they fit together like puzzle pieces when whole, mother and father pressed together, the boy nestled between them. But now they were broken, a thin gibbering wail coming from the child thrashing on the hospital floor, the mother frantic and pawing at his narrow chest, choking up sobs in great heaves, grappling for his flailing arms, while the father stood helplessly, opening and closing his hands into fists as if wishing for something to fight.
“Help me.” It wasn’t a scream, but more alarming because of the lowered tone and urgency of the woman. The man dropped to his knees and took the boy’s wrists in his big, rawboned hands. He was a laborer, that was clear, black haired and thick of waist. The boy shared his looks, dark hair, and sturdy build from what Lucy could see beyond the wreckage of the young face.
Lucy stepped closer. The child had swallowed his own lips and was now trying to gnaw off his fingers. She paused to set down her coffee on the nurses’ station and then moved toward the grisly trio.
“Cathy!” Lucy bellowed, using her most commanding voice to be heard over the boy’s gibbers. She’d been walking
past the admittance ward, headed back to the microscope for her morning slides, when she heard the commotion.
“Hold on, damn it,” a voice came from behind a partition.
The father grunted, cords standing out on his arms as he gripped the boy’s wrists tight to try to keep them away from the lipless, snapping jaws.
Cathy prairie-dogged up, spied Lucy, and ducked back down. Then she appeared around the corner carrying a first-aid kit, a packaged syringe, and a bottle.
The boy’s heart hammered away inside his rib cage, pushing tachycardia, and Lucy could feel the heat of his fever even before she touched him. She checked his pulse: 120 bpm or thereabouts. Hard to tell with him jittering in her grasp. He looked to be seven or eight years old, judging by size, strength, and muscle tone.
“I hope that’s a sedative you’re holding. This kid is out of control, Cath.”
Cathy frowned at her, then glanced at the mother and father.
Lucy winced.
The boy whipped his head around, slinging fine blood droplets, and sank his teeth into his father’s wrist. The man bellowed like an ox and tried to yank his arm away but only succeeded in pulling the child up from the floor.
Lucy struggled to prize the child’s jaws open, but he was latched on like a pit bull.
She turned and ripped the purse from the mother’s shoulder.
“What are you doing?” The woman’s eyes were wide.
Lucy put one hand on the boy’s forehead and shoved his
head down onto the tiles. At the sharp
crack
of impact, his mouth opened, releasing the man’s mangled wrist. Lucy stuffed the purse straps into the child’s mouth and reflexively he clamped down hard and groaned. Cathy, falling to her knees, sank a needle into his arm. He arched his back, bowing up and off the floor, slobbered and growled through the bit, and then relaxed.
The father slumped to the side, cradling his injured arm. The mother sobbed. Cathy reached out to the child’s mother, making comforting sounds.
Lucy stood and looked around. Another mother and child and an elderly couple were staring at her as if she had attacked the boy. As if she was some kind of monster.
This is why I don’t do wet work
, she thought.
My bedside manner sucks
.
Lucy felt an overwhelming need to leave. She forced herself to wait until Cathy had bandaged the child’s hands and done triage on what was left of his lips. Reconstructive surgery was going to work middling at best.
On her way out, Lucy retrieved her coffee. It was still warm.
Lucy loved cancer.
She loved the problems, the puzzles, the mystery of the disease, its pure viciousness and its strange recursive paths and tactics. It was a formidable opponent, and she respected it, in all its myriad forms.
Brushing hair from her face, Lucy leaned over the microscope and placed her eye to the ocular.
Purple foam of dotted circles: renal carcinoma. Black sky strewn with spider-shaped stars: probable sarcoma. A surf of sea-blue histocytes: classic chronic myeloproliferative leukemia—CML for short.
The zebra of the bunch showed bloody aspirate with no bony spicules, looking for all the world like the Cassiopeia constellation. Lucy took her time. She rechecked the chart. Twenty-seven, female, pregnant. The woman had smiled nervously at Lucy during the biopsy despite Lucy’s scowl and the needle burrowing into her flesh. She had brown eyes, Lucy remembered, and a little crook to her smile pulling her lip down. Her stomach was just beginning to pooch. She looked nice and maybe in a different world, if Lucy had been a different person, the two of them would have been friends.
But Lucy didn’t really have friends. She had a husband, Fred, and a child, Gus. And an electron microscope.
Look at the human body. Break it down into component parts. Skull, mandible, vertebrae snaking down between scapula and clavicle to the pelvis. Wreath that structure in a rich integument of flesh, muscle and sinew, and connective tissue wrapped around delicate, intricate organs that moved vital fluids about the body.
Raise your hand and flex your fingers
, she thought, eye to ocular,
and a million little exchanges within the chemical machine of your body result
. She raised her hand and adjusted the magnification of the microscope. The zebra was puzzling.
The mystery of the body
, she thought, and didn’t know if she was referring to the human body or the humans themselves. Easier to focus on the puzzles that she could solve, rather
than those she couldn’t.
Focus
, she thought as she twisted a knob on the microscope, causing a spray of cells in her vision to blossom and calcify.
For an instant, she thought back to the boy from earlier in the morning, spasming on the floor, lips and fingertips eaten away. There was a terrible look on the mother’s face, one Lucy didn’t think she’d ever seen before in all her years of medicine, and it was a great blank wall to her, beyond her understanding. A family in wreckage . . . Easier to think on the boy’s affliction. An ugly reality, to be sure, and puzzling too. What could’ve caused that behavior? What if that had been Gus?
She leaned back from the microscope’s viewfinder and allowed herself a moment to let her eyes rest. To think upon the boy on the floor.
She checked the slide again. The spray of stars showed her things that no astrologer could perceive, and she felt, for just an instant, an intense moment of joy as she discerned the nature of their arrangement, the problem solved. No doubt about it, mature B cell neoplasm. Packed marrow.
Cancer, you old devil, come to visit here again
. Then the realization that always followed, like guilt after masturbation, that the cancerous cells didn’t exist solely on a microscope slide. They had been part of a greater whole, once. She’d removed them from a woman. A woman with nice hair, a wedding band, a crooked smile, and a maternity clothing catalogue peeking from her purse.
How do you tell a patient that her child will never be born? Due to her cancer, she’ll miscarry far before term?
Delicately.
Which presented a problem for Lucy. For delicacy, she
relied on residents. She was the brain. Let the hands give comfort. Let the mouths speak platitudes, impart the bad news, and soften the blow.
Lucy leaned back and rubbed her eyes.
As she made her notations on the chart of the woman with Burkitt lymphoma, Dr. Robbins poked his head into her office.
“I need you to help us, Lucy. It’s all hands on deck,” he said, blinking. She winced at the sailing reference. “The waiting room’s going mad, just packed to the gills.”
Lucy tucked a wild strand of hair behind her ear and said, “So, what else is new?”
“Right. It’s always a madhouse. But this is different, Luce. Something strange is going on.” He bit his lip, and she thought of the boy again.
“Okay.” The rack of samples could wait.
In the hall, Robbins walked with his hands in his pockets, his head bowed.
“So what’s up?” Lucy asked. She wasn’t used to having to prod Robbins. A pediatrician, he had florid cheeks and, usually, a jovial disposition.
“There’s something going on and I think—”
Robbins looked up and Lucy saw concern etched into his face. His clothes were disheveled and his face showed two days’ growth of beard. This was SOP, but he usually smiled.
“The stockpile—”
“What about it?”
“Why are we here?” he asked. His voice stayed soft, but she could still hear the stress rippling through him. “We’re here because this town grew up around the chemical stockpile.
And the adjacent military base. We’re in the poorest county in America, maybe—definitely one of the poorest in Arkansas. With most of its population either in the military or feeding off of it.”
Lucy shrugged. “I don’t understand what you’re talking about, Robby. You’re not making sense.”
He frowned and squared his shoulders.
“Let’s go to the waiting room and I’ll show you.”
He turned and walked away, shoes clacking on the virulent green tiles, into the wash of light from the window. She jogged to catch up.
She had almost rejoined him when they neared the double doors that served as a barrier between reception, atrium, the waiting room, and the rest of the clinic. Through the metal and plastic of the doors sounded the screaming of adults, the cries of children.
Robbins popped the circular metal button on the wall and the double doors swung open with a hiss.
The noise was deafening. Lucy’s step faltered.
People lay strewn everywhere. Mothers huddled in plastic chairs and clutched squalling babes. Old men cursed and scowled. Women cried and children screamed in pain. At least two elderly lay upon the cheap, gum-spotted carpet.
The waiting room was a menagerie of neurological errata and dysfunction. When Lucy was younger, interning in the psychiatric ward of the state hospital, the chief resident had sung “Dysfunction Junction” to the tune of the old Saturday morning cartoon “Conjunction Junction.” He would’ve been howling now.
The receptionists had shut the receiving windows and were hiding in the office, as far as Lucy could tell. Two orderlies grappled with an older man whose arms shook and rippled with muscle tremors as he bellowed curses. Cathy and Melissa, a high-school volunteer, walked through the room, handing out forms to those able to hold them.
Closer to Lucy, a male barked, then grunted. She turned to look.
An elderly man on the floor contorted his back into a painful half-moon, only his head and heels touching the floor. His fists were balled and pressed into his thighs.
Opisthotonus
. Lucy had seen this in textbooks but never in person. Tetanus could bring on such dramatic contortions.
A gray-haired woman sat near the man, looking away from his horrible position. She spoke in a low, urgent voice.
“Shit on me. Crap in my hair. Dogshit. Sucking cock. Cum-gargling. Assfuck. Christfuck. Virginwhore. Godquim—”
A boy stood stock still in the center of the room. Every muscle of his body was contracted, locking him into an almost farcical position: one arm out, halfway extended, hand closed and palm up, the other grasping his side. He looked as though he might begin fencing.
A black girl no more than ten thrashed on the floor, spasming and foaming at the mouth. Her hands bled, leaving red curlicues on the carpet. Her mother stood above her, wringing her hands, as the father pressed himself against her in a feeble attempt to smother the spasms. The girl brought red-tipped fingers to her mouth and began to bite.
Whatever that boy had this morning, it’s catching
.
“Please, Doctor. Help my baby, she won’t stop crying.”
Someone tugged on Lucy’s sleeve. She turned to look. A woman with a swaddled babe in her arms. Robbins approached.
“Jesus Christ, Robby.” Lucy felt at her pockets, helplessly, as if something there might help her. “Self-ingestion. Self-violence. Spasms and seizures. It’s like all of the big weird neurological baddies have manifested themselves in our waiting room.”
“Doctor?” The woman’s voice was desperate, lost and urgent. “Please help my baby.”
She looked at Lucy with wide, clear eyes. The child screamed, a high-pitched ululation, and then stuffed its hand into its mouth.
“Come with me,” Lucy said.
With mother and child in tow, Lucy pushed her way through the crowd. As Lucy passed, a tottering old lady flopped to the floor, and each limb began to twitch independently of the others, as if the woman’s body had suffered a schizophrenic break.