Empty

“Get him on left lateral, clear the surroundings, siderails up!”

Emma hears the orders before she registers the man lying on the bed violently jerking both arms and legs a foot from where she stands at the triage desk. The back of his head thumps on the bed repeatedly. The woman waiting her turn at the doorway lets out a scream that pierces the silence that befell the emergency room. Healthcare professionals and patients alike all stand with bated breath, waiting for the man’s seizure to end.

A minute later the man’s muscles cease their contractions. Sound and color seeps back into the area and Emma lets out a sigh, sagging her shoulders. Another day, another crisis. Will it ever end?

She rushes over to the post-seizure man, wincing at the tangy smell of vomit emitting from his mouth. Time to suction, assess, and inquire. She does a double-take, recognizing the man from last week.

Emma turns to the emergency medical technician that brought him in. “What’s his condition?”

“Blood pressure’s 200/110, O2’s at 85%, heart rate 160. Complained of severe chest pain and blurred vision upon arrival.”

The man groans. “M-my chest hurts… can’t-” he gasps- “breathe-”

A million things run through Emma’s head at that moment, running through treatment algorithms, anticipating doctor’s orders and medications, while her hands work to obtain vital signs and suction.

A physician rushes over and Emma gives her report. “He was here last week. Had a stroke and refused to stay for monitoring. Couldn’t afford the bills. I don’t think he took his medications.”

The physician nods. “It looks like a hypertensive crisis. Get the oxygen and the antihypertensives. This man needs an airway and O2 stat!”

-----

“Mr. Harvey, we would really recommend that you stay a few more nights for monitoring. You had a stroke yesterday. Your blood pressure was very high.”

“You said you guys have lowered it right? Isn’t it back to normal now?” Mr. Harvey gathers his bag and takes off his hospital gown, revealing a sweater and jeans that have definitely seen better days.

“Yes, your blood pressure has lowered, but it’s far from normal. You have high blood pressure Mr. Harvey. It needs to be managed or it could get worse. We don’t want you coming back in here with another stroke.” Emma stands in front of Mr. Harvey’s way, trying to get him to listen.

“I understand that, and I understand your concern, but I just can’t afford it. And my kids need me. I need to get back to work.” Mr. Harvey looks around the room to see if he’s left anything else.

Satisfied, he looks at Emma. “Now is there something I need to sign?”

Emma sighs, massaging her temples. She’s seen this more times than she could count. Last time it was a cancer patient refusing treatment because she couldn’t afford the surgery. Before that was a diabetic woman with a foot ulcer insisting on going home to take care of her children. Neither of them ended up well. Now, it’s Mr. Harvey.

“Very well, we will put you down as discharged against medical orders. You can sign at the front desk.” She steps out of the way. “At least remember to exercise, watch your diet, and take your medications,” she says in a last-ditch attempt at patient education, but it fell on deaf ears.

“Thank you, I do appreciate what you have done for me.” Mr. Harvey steps past her, but not before Emma hears him mumble, “Like I can afford medications. That ambulance was just too expensive. I’ll have to work overtime to pay it now.”

Taking in a deep breath, Emma shuts her eyes for a second. Hope he doesn’t need to come back.

-----

Mr. Harvey is completely still. Too still, Emma thinks. She takes a look at his chest.

It’s not moving.

She places two fingers on the inside of his wrist. Waits a second. Nothing.

Her worst fear is coming. She hates when she’s right. She’d rather be wrong.

“He’s not breathing. I have no pulse! He’s going into cardiac arrest. Beginning chest compressions,” Emma places her hands on his chest and begins to count. The rest of the team works in unison to get the CPR board and begin ventilations.

A bead of sweat drips down her face. She glances over at the cardiac monitor. He’s flatlining. He’s been flatlining.

“Emma, stop,” the physician puts a hand over hers, still on Mr. Harvey’s chest. “He’s gone. It’s over.” He removes her hands from the corpse.

-------

“You know why I can’t accept this? Huh?” She paces. “Because it could have been avoided. Yes, avoided. But he-he couldn’t afford it. He-the bills were too much. I thought it was our job to help those who couldn’t care for themselves. But he forced himself to walk away because he didn’t have the money to take care of himself. And now-now he’s dead. Just like all the others. Do you know how many people I’ve had to see die because they couldn’t afford to pay those rich assholes sitting in charge in their little offices? They treat us like pawns in their game. No. I have a conscience. I can no longer do this. I began this career to help people. I can’t. I quit. I’m sorry.”

-------

The walls close in on her, the hands growing out from them reaching towards her. Emma gasps for air, clawing at her neck. She bolts upright in her bed to the sound of her phone ringing.

“Why are you calling so—”

“Mayor Davis—” Her secretary speaks at the same time. Emma sighs.

“Speak.”

“Mayor, there’s an urgent document requiring your approval. Do you think you could—I mean I know it’s early—”

“Yes, yes I’m already up. I’m coming,” Emma was already halfway to the bathroom. Just another useless contract to sign that she knows nothing about.

“Thank you, Mayor. My apologies for bothering--” her secretary said. Emma deigned her no reply and hung up before her secretary finished her last sentence. Her mind had already drifted back to the nightmare she had, the events that had happened in another life, all those years ago. Mr. Harvey’s death haunted her dreams even now, eight years later, disturbing her rest and waking her with sweat trickling down her back and hungering for air. She supposed that’s how Mr. Harvey felt when he died.

Today was the anniversary of his death.

The moment Emma thought about sitting in her car, she began to hyperventilate. Not today. She decided that walking to work would be a better option.

It was an hour before Emma had to actually stop for a traffic light. An amazing feat in this city where every light seemed to always work against your favor. Emma had actually not wanted to rush today and wanted traffic to delay her, but no dice.

In an attempt to stall for time, Emma took a long look at her surroundings. At the corner of the intersection was Chase bank with graffiti on its walls, and above it was train tracks. This early in the morning, there were only a couple of stragglers on the street, going home from a night out. There was a trash can at the very edge of the sidewalk corner, overflowing with napkins, coffee cups, and three bags full of bread. Emma couldn’t fathom why someone would throw out perfectly good food.

Her eyes moved a few feet left of the garbage can and downwards. Oh. It was a homeless person. He sat atop a small square of cardboard, huddled in a small space created by two adjacent support beams of the train tracks. His hands were shrunken into his dirty brown sweater that had many more holes than the usual four. In front of him was a sign that read, “Veteran. Would appreciate any bit of help.”

Emma felt like she hadn’t looked for a long time. It didn’t feel like the same city it was eight years ago. Or maybe it was and she just hadn’t noticed.

Her phone rings again, pulling her out from between the webs of her thoughts. It was her secretary again. Emma dismisses the call and crosses the street to enter her office.

-----

The forecast called for snow flurries today, but the cool air froze her insides and it felt as good to her as black coffee does to those who have tasted the bitter of life.

Emma decided to walk to work every day now, and each day, the homeless man was there without fail. So, she wasn’t surprised when she saw him there today too, regardless of the weather. His arms were shrunken into the same sweater as last time, but this time Emma could see him shaking. Even Emma was shivering waiting for the light to turn green, and she was wearing the largest coat known to man.

Just then, a little girl breaks away from her mother and runs out into the street. A car blares its horn, approaching the girl standing in the middle of the road with a red light. Emma doesn’t have time to even think when she sees a blur pass her, dash to the girl, scoop her up, and bring her right back to her mother.

The mother is hysterical. Emma is hysterical. She doesn’t make a sound, but tears stream down her face, dripping onto her oversized jacket. She doesn’t think she can handle witnessing one more death.

Through the tears in her vision, she sees the mother thank the man. Realizing he is the homeless man, her eyes immediately narrow as she backs away, stuttering a thank you. The light changes and she, holding her daughter’s hand, fast walks away.

Emma’s eyebrows knit together at the way this man is treated.

She brushes away at her tears, trying to look normal before entering the office.

“Good morning, Wanda,” she greets her secretary. Wanda’s eyes widen.

“G-good morning Mayor Davis,” she replies.

“I have a question. Don’t we have homeless shelters? Why don’t the homeless just go there instead of being on the streets?”

Wanda’s mouth opens and closes like a fish. “Sorry, Mayor, I am not sure. I suppose homeless shelters aren’t that safe?”

Emma’s eyes narrow. “Hmm.” She glances over at her office door with the title ‘Mayor Emma Davis’ printed in large block print.

Settling in at her desk, she types into Google, ‘Are homeless shelters dangerous?’

Over a million results were brought up and Emma spent the rest of the day poring over them. She learned that people get their shoes stolen and come out with body lice after going to homeless shelters. They’re cramped, they lack ventilation, there are drug dealers, the list went on.

Emma leaned back in her chair, holding her fingers against her throbbing temple. 4% of her city’s population were homeless. How did I let this happen? Emma’s face lit up in shame. Her eyes welled up. She hadn’t felt this useless since the day the physician removed her hands from Mr. Harvey’s cooling body.

She runs out of chair then, calling for Wanda.

“You called, Mayor Davis?”

“Yes. Get together a team. Let’s build a plan to combat homelessness.”

-----

“Mayor Davis, I understand that the percentage of homeless in our city is not an ideal number, but we simply do not have the funding to help them. Most people can barely keep themselves out of poverty. The healthcare system is crippled and there are just so many more areas that require our resources,” said First Deputy Mayor Mitchell.

“The healthcare system is crippled because it is flawed. However, we aren’t here to discuss that right now, and we can only solve one problem at a time. My plan does not require more funding than we are already using for the homeless. It is simply a reallocation of resources. Restaurant owners throw out large quantities of leftover food at the end of the day. I’ve talked to small business owners and many have agreed that donating that food is much better than having it go to waste. We can offer to collect the food at night in a refrigerated truck and dole our portions the next day, moving into frequently populated homeless areas.

“There have been multiple philanthropists willing to invest some money to help us create a non-profit to help the homeless find jobs. We’ll have multiple small establishments for homeless people to shower, dress, and give interview and job prep. The NPO will partner with local and big businesses to offer homeless people jobs. Of course, they will need to go through background checks, and all employees must be vetted.”

“I think it’s a good plan,” one person said.

“Agreed. Let’s proceed with the plan,” another said. Mitchell throws up his hands. “Very well, I suppose I can’t convince you. Do what you wish.” He walks out the door.

------

“Wanda, I’m going to Grand Central,” Emma grabs her coat and brushes out the door.

“Mayor, there’s a lot of homeless there. It may be dangerous. I don’t advise it,” Wanda said. Emma wondered when Wanda became so brave that she would advise her to do something.

“Wanda. That’s the point. The details of this program have been ironed out, but no one’s coming. Are you coming with me?”

“Like I have a choice,” Wanda mumbled.

“I heard that.”

------

“The system was always out to get us, coming after us & our families when we were making money, and now that we lose our job in budget cuts, the system is unwilling to help us. Now I got no house, no wife, and no children. You can’t help us.”

“Yeah, get out of here! You don’t belong here!” someone calls.

“Leave!”

Emma wordlessly gives them each a ten-dollar bill. They quiet down.

“Alright!” someone yells. She doesn’t flinch.

As she turns to leave, a girl tugs on her mother’s hand, “Mom, I’m hungry. I don’t want to be dirty anymore.”

Emma waits two seconds. “Wait!” She turns.

“If you are willing to help me…I am willing to accept it.”

Emma smiles. Her cheeks felt stiff, and her lips had trouble curving upward, but it felt good. It felt like her first genuine smile in a decade. “Thank you for believing in me.”

------

Emma had stopped walking to work, anxious to get there as soon as she can. There was always more work to be done.

But today, she decides to go back to the carboards beneath the train tracks next to the garbage can in front of the bank. Without fail, the man is still there. She stands there for two minutes, debating.

Just then a train passes by, dripping water down on her face. She scrunches her face in disgust. Then she realizes he sits under this every day. She wonders if he ever leaves. He always seems to be there.

She makes a split-second decision, heading into a nearby store. She buys a blanket and a coat. She gets a sandwich and a bottle of water. She comes out the store and without hesitating, walks up to the man.

She holds out her open hand at him. “Good day sir.”