Allison Raeck

White walls, blue gloves, sterile.

Everything was sterile. 

He entered the room as usual, clad head-to-toe in starchy blue scrubs, pristine for now. He was all blue all around, except for his eyes. The dark brown spheres peered between fragments of cloth. If he were to have it his way, his eyes would be covered as well, for with his eyes alone exposed he felt naked. They revealed a trickle of anticipation and a mound of fear stemming from irreversible past defeat.

A row of dependent eyes turned to the door as he entered. Not so long ago, he could recall, he lived for this very moment. He once felt like he were at the top of the highest roller coaster in the world, full of excitement and optimism that the ride would be painless and that the cart would remain securely on the tracks, because that’s just the way the ride worked. But after several encounters with flat monitors and crying mothers, the flame in his eyes was stifled. Too quickly, he found that life came and went easier than he was led to believe.

“We are ready to begin the procedure.”

The heart monitor set a steady pace for the dance, a metronome of sorts. Beep…beep…incision. Beep…beep…drip. Deep…deep…down. A sea of red lay before his eyes, familiar. Regardless of ailment, nearly every person’s insides looked the same. He liked this uniformity. The facets and layers of the heart, the crimson aorta stemming into veins and arteries of deep-indigo, intricately weaved and branched around each ventricle like the roots of a one-hundred-year-old tree. Its valves worked alongside one another in perfect harmony, immaculately engineered to stimulate life within the human body, a well-oiled machine. But one kink in the system, one tiny fracture of the septum or hole in a ventricle, had the potential to ruin everything. Life was as delicate as the machine from which it was built. He had looked at hundreds of hearts, each presenting the same general symmetry; he found the essence of one’s true self within their rushing blood and organs, rather on than their face.

He knew that morphine didn’t help the patient as much as it helped him. Anonymity. He detested speaking with his patients, for fear of growing attached. Never grow attached. He was simply a mechanic, a name that appeared on various clipboards. He had learned this in time. When he talked, he grew close. And when he grew close, he lost.

“I don’t know what’s wrong with these women,” his mother chimed, her voice growing increasingly aggressive as she began her dramatic introduction. “If I were young, I’d take advantage of this. Who wouldn’t want to marry a doctor? No, not just a doctor, a surgeon?”

Every time they had this conversation, he could feel his blood pressure steadily increase. Isaac’s mother called both him his sister, Rachel, nearly every day. Since his father left, she had nobody to complain to on a daily basis other than her children. Each evening, her shrill voice would fill Isaac’s apartment like steam bursting through a manhole on the busy city street. He knew the only thing he could do was to let her cool off and get it all out.

He set his phone on speaker and went down the hall to hang up the dry cleaning. Across the apartment, he could still hear every word lathered in her thick, New York accent, a dialect that transitioned with her from her upbringing in Brooklyn to her nuclear family on Long Island. For the most part, anyone could tell her entire life story solely through her distinct vowel sounds. There was nothing enigmatic about his mother, not even the fraudulent youthful complexion, provided by years of Botox injections, which she thought to be such a mystery to the rest of the world.

“I don’t have time for anything else right now, Mom,” he shouted, hoping she wouldn’t notice that he had begun recycling excuses. And it wasn’t entirely an excuse, he told himself. It was the truth. He didn’t have the time. He had to focus on his career. But he knew what was coming next.

“I didn’t pay for your med school so you could live alone for the rest of your life,” she recited, her usual response. “You aren’t gettin’ any younger. Go find a nice girl and give me some grandkids while ya still can.” The words used to roll off him like drops of water, but now weighed him down, heavy. They sounded different these days, as though each criticism was tattooed onto his skin. Years ago he wrote her off as crazy, as impatient, as a classic case of a mother wanting to ensure the legacy of her family name. But now he heard them for what they meant. Because, though he could not admit it, out loud or even in his own thoughts, he knew she was right.

Isaac never had recurring dreams before the incident. Now, every time he tried to find refuge in sleep, vivid memories flashed in his mind, transfusing realistic details with guilt-driven exaggeration. The beginning was always just as it had happened those five months ago: he hovered over the woman’s heart, his hand steady as his scalpel made the initial incision. For some reason, in this dream, he always stood alone, without the hordes of nurses and students surrounding the operating table to pass clamps and dilators and scribble notes on clipboards. Instead, he stood deserted; this was his fault and his fault only.

By the time the reactor was properly placed, prying open the woman’s chest and literally exposing her vulnerable heart to the world, he was able to begin. He peeled back the pale pericardium skin, as he had countless times before. It had all grown quite monotonous, really. Even when split seconds served as paper walls between life and death, it was just another day at work.

Until he slipped. In an attempt to find a stubborn artery hidden within the heart’s stubborn cardiac muscle, the aortic valve had been severed. Too many moments had passed before he realized this mistake. Deep crimson waves poured from the valve, like a stream of cars in rush hour when the light turns green. The more it poured, the bigger the slit grew, eventually cutting off the supply of invaluable blood to the ventricles and, as a result, cutting off her life. She would be alive, had he noticed right away. She would be alive, had he taken the time to more patiently and precisely locate the artery. She would be alive, had the unexpected tedium of his daily life not distracted him from the gross amount of trust that was placed in his hands.

Once he realized what he had done, his heart convulsed, as torn and severed as the one that lay before him. In this dream, the blood never stopped pouring, over the edges of the operating table, splatting into a pool on the blue-and-white tiled floor, gallons on gallons leaving him knee-deep in remorse that would never wash away.

With an image of the woman’s heart still etched in Isaac’s mind, he jolted awake. Though there were still three hours before he needed to be up for work, he knew that falling back asleep would only send him to that same operating room, forcing him to relive the trauma endlessly in an ever-beating cycle.

“I’ll come downtown tonight to meet you for dinner,” she said. Isaac’s mother was always trying to get him to eat with her, at the same Italian restaurant where she would inevitably order baked rigatoni and complain to the waitress that the cheese was “too thin.”

“Not tonight, Mom, I’m too tired,” he replied. He thought about adding “Maybe some other time,” but, knowing she would hold him accountable for this offer, he refrained.

“You’ve been so sullen lately and you never do anything,” she began one of her tangents. “I don’t know what’s gotten into you or what hours they have you working, but you need to go out and start a family. Why can’t you be more like your sister? Rachel has a boyfriend, a nice boy, and she worked hard to find him. She said she’s been dropping hints and she thinks he’ll propose by New Year’s. Propose. See, a girl isn’t just going to burst into your life, Isaac. Ya gotta try harder.”

Try harder. Something she had been telling him since his Ivy League applications, since his days pouring over textbooks in medical school, since his apprenticeships in the hospital when, for a split moment, he considered that cardiovascular surgery may not be the field for him. No, she always told him. Try harder.

Hanging up the phone, he pictured his mother hanging up hers, shaking her head feverishly as she always did when she was stressed. If she knew what he was going through, what flooded his dreams, would she still press him to constantly “try harder?” Yes, he thought. She would. Isaac knew his mother had planned out his life from the day she gave birth to him, down to where he would go to medical school and when he would get married. Any deviation from this plan sent her into waves of anxiety. Years ago, when Isaac had suggested going to college in California, she spiraled into a wave of panic and defense, stress-eating bags of Doritos and assuring him that he would be going to Columbia. And, of course, he did.

Isaac could picture his own heart pounding; he felt like he couldn’t breathe; the girl behind the glass had recognized him this time.

He always noticed her, since she always worked the same nights that he came by. They had gone to the same high school a decade and a half ago, but she had never known who he was. Those days, he could name most every face in the hallway. He was an observer, utilizing his impeccable memory to store intricate details about the people who surrounded him. He knew what bands they liked, where they lived in the city, who they were sleeping around with. Of course, none of them knew who he was. Isaac watched from afar.

She smiled and asked, in a tone that he could only describe as ringing, “Just one ticket again this time?” He knew he would have to find a new theater from now on.

“No, two actually,” he replied. “I have someone meeting me later.” He crumpled the second ticket into his back pocket once he’d passed her. Why were people always trying to know things about him? All he wanted to do was go to the movies, a simple request. He shouldn’t have to explain his life story to get in the door.

Isaac started going to the movies more after the incident. Painful memories constantly echoed within his mind, distancing himself from others as a method of punishment. I am a killer, he thought, often at random intervals throughout the day. Whether he was sitting in a cab or heating frozen vegetables for dinner, he could never forget. I killed a woman. He spent his nights off desperately attempting to silence the voices in his head, either drowning them in dark whiskey or hiding them behind the big screen.

Today’s film was part of his ritual; he bought a ticket to the nearest showtime, regardless of the title, and walked into the first screening that still had its door open. He didn’t look up at the name of what was playing in the scrolling sign above the entryway. Usually if it was a cartoon, he would leave right away and find another open theater; even when he was a child himself, he never really understood their humor. But sometimes, depending on his mood, he stuck around.

He played a game with himself where he would try to guess the movie’s genre based on the people sitting around him. Today the place was empty, save for a couple in their early-twenties near the front, and a group of five or six geriatric women wearing matching purple hats. Nobody else had come in by the time the lights dimmed. He leaned back in his seat and let the flashing lights of Hollywood hypnotize him again, a soft anesthesia to send him drifting into a world of someone else’s problems and, more often than not, someone else’s happy ending.

It was exactly 2:37 a.m. when his phone rang, jarring him away from his ever-present nightmare. He shot upright in bed and envisioned what tragedy waited on the other line. The EKG found murmurs from that newborn again? Was her skin turning blue? Was it too late? But instead of a nurse’s hurried, professional tone answering, it was another familiar voice. Rachel. The rapid pounding of his heart ceased, no longer ringing in his ears. His sister was probably out at some club again, drunk on something turquoise and about to echo the same complaints as his mother.

“What do you want?” he mumbled, rolling his eyes and collapsing back down onto the mattress.

“Isaac. It’s about Mom,” she said. Her voice sunk halfway through the word “Mom,” into the raspy tone that he remembered from their childhood, when she would scrape her knee and attempt to hold back tears. His heart sank again. “They said her heart stopped…all at once but…she just laid there in the hallway until her neighbor came by…” Whenever Rachel got upset, she spoke in fragmented, incomprehensible bits of information, a collage of words together delivering utter chaos. But Isaac knew exactly what she was trying to say.

“She’s dead, isn’t she,” he asked, the room around him spinning and the walls slowly creeping inward. The silence on the other line answered his question.

He didn’t realize his entire body was shaking until after he hung up. It was reminiscent of the mix of uninterrupted adrenaline and panic he got after those other late-night calls, the ones that involved patients’ stalled breathing, flat lines on the monitor, and complexions matching his pristine blue mask. But this time it was his mother.

Though he had worked on the cardiovascular floor for a couple of years, everything suddenly felt different to Isaac. The ceiling seemed lower, the temperature-controlled waiting room seemed warmer, the nurses whom he all knew by name seemed foreign, distanced, and unsmiling. With his eyes glazed over and in a haze, he staggered to the elevator and fervently jammed the up button seven times, as though that would make the process any quicker.

All was quiet when he got to the top floor, and the elevator’s ring echoed through the hall like a scene from a horror film he’d seen last Wednesday. Isaac hadn't been on the roof since he first started working at the hospital. “The view up there is crazy,” a nurse had told him. “You can see all of Manhattan. All the lights.”

As he opened the door at the top of the thin staircase, he was greeted by the unforgiving New York wind, and his warm tears suddenly burned his cheeks.

Standing near the building’s edge, Isaac absorbed the city before him. He looked down. 70th street lay below, weaving into Madison Avenue and, eventually, countless other roads, lanes and boulevards that would serve as the veins to support a bustling, busy city. The island’s lifeblood. Inhaling sharply, the frigid, smoggy air inflated his lungs. Yellow and gold lights speckled the buildings before him; he considered how they each held someone else’s story, which was probably more worthwhile than his own. A million little lights, a million beating hearts. Most hearts would fall in love, he thought. But all of them would inevitably stop beating, one day.