My memory has no room left to store new memories; that the memories I do have are losing their roots and turning into a mass of dust that still occupies the same amount of space; that I’m making up new memories to replace the old memories and therefore I’m not sure of who I am or where I’ve come from, or whether or not my sister really did kill my goldfish when I was five years old. The other day I was getting a drink out of my refrigerator, and there was a container of blueberries sitting on the shelf and I couldn’t, not for the life of me, remember putting it there. This troubles me, in a small way, and I wonder if anything that I remember when I’m 90 years old will actually be true, if any of it will still have form and texture versus a mass of blurred edges. I wonder, too, if I will mistake my girlfriend for my hat.

It is getting harder to focus when there are shiny objects and moving objects and beautiful objects to look at and play with and take apart into tiny pieces that I can roll around between my thumb and index finger. The other day I took a test that was designed to assess my ability to focus. As it turns out, I scored as a highly focused person who can eliminate distractions and keep things in my short-term memory longer than those who are less focused. In other words, I’m not very good at multitasking. I don’t know that any of this is true because I merely wanted to win the game and get as many points as possible. Days later, I sit at a bar and edit a paper that a friend of mine wrote. In the background there is loud music with a lot of people coming and going. The bartender comments on my ability to tune everything out and focus on whatever it is that I’m focusing on with all the busyness of the bar. For a few moments I realize that the test might actually be correct.

Summer is never going to arrive and Seattle is never going to get any warmer than it is today, which is roughly in the mid 60s; that it will be early July before I can stop wearing my fully zipped-up jacket; that I won’t have a reason to wear sunglasses other than my usual disdain for bright light; that the rain I love so much is never going to break, never going to allow for a moment of reprieve with a canvas of blue sky; that my insides are never going to fully melt, leaving everything a soggy half-frozen mess that begs to be mopped up and air-dried. The other day I was hiking in the mountains with some friends, moving through pockets of cool air and warmth with a dog named Sarah who jumped into the air to catch flying snowballs. As we hiked up the ridge there was a rushing sound in the background, and we all stood quietly and listened to the avalanche that was falling from a mountain peak just across the way. It is getting warmer, somewhere, just not here at home—not yet. At least not enough that I can stop wrapping my hands around steaming cups of chai.

I sit in a cafe and eat oatmeal—with nuts and berries and brown sugar—and drink tea and wait for a store to open just three doors down. I buy things that are designed to enhance the goofing-off aspects of my life, and when I pile the goods into my car there is an immense sense of guilt that fades, later, after pints of Pilsner and good conversation with good friends.

We talk about summer and sunshine, about how life can often feel crazy wonderful, about how cancer has the power to reset half a dozen switches, about how happy hour quesadillas taste exponentially better than the ones on the regular menu, and about how beer tastes so damn good when it hits the tip of your tongue.

I plan things to do for the summer, try to define a fragmented path that involves music and motorcycles and friends and mountains and oceans and extensive moments of solace. All of this makes me grin, and I can feel the way my smile reaches toward my ears, and this feels good in a very deep way.

•   •   •   •
I think, sometimes, that I am supposed to be somewhere that I am not.

I think, also, that I am supposed to slow my life down, let my heart rest, let things slip into a blurry cloud of soft edges.

•   •   •   •
James wraps his arms around me, pulls tight and kisses my cheek. I love him for this. Love the way we have a fondness for one another.

Chris tells me about his cancer, tells me how he’s been doing Vitamin C infusions, tells me how proud he’s going to be of me this weekend.

Tricia and I talk about heart and matter and things that matter to the heart. We talk to Basil and talk about Bobby and talk about how we need to see Bobby for one last hurrah, about how he has one of the best hearts of anyone that either of us has ever known.

•   •   •   •
I’ve been thinking of how my heart rate continues to slow. I think, too, about the billion-heart-beat theory, and I think that a resting heart rate that hovers just above 50 beats per minute might be a good thing.

I’ve also been thinking about tea and caffeine and the way it makes my heart quicken. I think, too, about the beats that my heart skips, and I think about the way it feels inside my chest when it happens.

•   •   •   •
I need to read more, need to learn new things. I feel like I need to spend less time staring out the window and more time learning how to play guitar, speak spanish, pick locks.

I am on a stretch of nine days off and my goal is to read and learn and lounge and delve into the way beers feel when it hits the tip of my tongue.

And I’m going to Gay Pride because it promises beer and friends and lovers and quesadillas and laughter. It also promises a boy named Mason, who has shown me that love is able to echo inside the chambers of my slowing, skipping heart.

When I walk outside my door, into the cold and dark and not-quite-midnight night, I can smell salt in the air, and it stops me just one step after my brain registers the smell of the ocean. I stand still for what seems like minutes or hours or days, close my eyes and slow my breath so I can linger with the salt and the air and the way it feels like I’m floating somewhere deep inside the ocean, embraced within its palm.

After awhile I forget why I went outside, and then I start to shiver because it’s cold and I’m not dressed for standing outside at midnight in weather that feels more like October and less like the middle of June. The sky is starless and moonless, buffered by a seemingly endless blanket of clouds.

Years ago, more than 20 now, I fell in love with the ocean in a way that nothing else in life can touch. It became, as someone expressed in words that I never wanted to use, my other lover. It is not, though, my other lover; it is my primary lover, and there is no getting around this, no way to downgrade or rationalize or theorize anything less, or more, than what it is.

There is the moon, too, the moon that slips into my heart with every beam of light. If I could find passage there I’d soak and melt and burn into its luminosity then launch myself toward the ocean, slam my entirety into the salt and the water and explode into brilliant fragments of light-filled energy.

The moon, maybe, is my other lover. But when I think about that, think about the the idea that the moon is something less than the ocean makes me feel like I can’t breathe. So I begin to understand all the angles, the way the points come together, eliminating the fragileness of “primary” and “secondary.”

Eventually I go back inside, feel my skin start to warm, wrap my hands around a steaming cup of tea. Later I drift into sleep and wonder if my body, in dreamland, will follow the salt-filled air out into the middle of a thunderous wave.

I drove home in silence because silence and solitude are more important to my well-being than anything else. Beer comes in at a very close third.

I watched a movie called “The Price of Milk,” and I realized that I’m not crazy, but most of the women I’ve dated are, indeed, crazy. Two of them rank the highest on the Crazy Scale: Girlfriend #1 and Girlfriend #4.

I hugged a friend in a really intimate way. And since there was no sexual tension, it was merely a deep and loving hug. We share a fondness for one another, an admiration that goes deep. I think, for a quick moment, that one or both of us would like for me to score a little lower on the Kinsey scale.

I met a woman with silver hair and an infectious smile. We talked about food and health and things that make us feel good. I wanted to read her palm, but I had no reason to reach for her hand. We share the same birthdate; she made me smile, all the way to my heart; she smelled like spring. She was having a heart attack.

I ran on a trail in a park near my house down by the lake. I ran eight laps, and whenever I rounded the final leg of each lap, small birds would follow me, circle around like they were sewing a luminous orb of protection. They were as small as my hand, some of them blue in color, and sometimes they came so close that I wondered if our bodies would collide.

I stood in the sunshine in a park a few blocks from my house. I raised my arms out at my sides, turned my palms toward the sky, closed my eyes, looked upward and turned in slow circles while I inhaled slowly and deeply with each rotation.

I was reading a book that said we should stop using quarter hours to indicate when we’ll meet someone. Instead, we should use random times: “I’ll be there at 3:03 p.m.” or “let’s have dinner at 5:47 p.m.” I have a work partner who goes to the gym with me whenever we work together, and we always say that we will go workout at 5:22 p.m. This always makes me laugh, always. We started doing this before I started reading this book.

I held a boy in my arms, and when he wrapped his tiny arms around my neck and sunk his head into my shoulder, I felt something in my heart scream with love. And I learned that letting a kid drink apple juice leads to an explosive bowel movement that leads to leaking diapers that leads to terror on the part of the person who is holding him.

On the way home from work, the inside of my head is groggy and fuzzy and blurry. I am operating on three and a half hours of fragmented sleep, and I need to concentrate harder than normal to focus on the road, the rain, and the speeding commuters as I look out my dirt-smeared windshield that gets more blurred each time the wipers slide across the glass.

I like going home when people are going to work. I like that feeling of being the lucky fish swimming downstream instead of upstream. I like sitting in cafes reading books and magazines while people come inside to get their coffee and begin their eight- to ten-hour work day.

I sit inside a coffee house, drink chai tea and listen to jazz. A boy walks in with his sister, and I think that he looks to be about seven years old, maybe eight, and he stands near the counter and moves his head back and forth like a chicken all the while he shakes his arms and his legs in some mysterious rhythmical way. I want, almost desperately, to know what is playing inside his head.

I start the descent down from the mountain pass and notice a rainbow arching across the highway. This is the first time I have seen a rainbow so close to me, and I realize that I am going to drive directly beneath it, or maybe I’m going to drive directly through its mythological end where I should slam on my brakes and jump outside, rummage through rocks and remnants of snow and puddles of water and shrubs of plants to see if I can find the treasure that lies beneath. As I get closer, close enough to reach out and touch its colors and maybe slide down its arch, it disappears with the laws of science.

When I get home there is stillness and silence and a delightful absence of people. I decide to go for a run, by the lake that‘s just over the hill from my house, follow the path for as long as my body feels like running. Whenever I think that I should turn around, go back home, I look ahead and see the curve of the path and wonder what it would feel like if I could slide the tips of my fingers along the smoothness of its edge, so I keep running until it is finally time to rest. Later, when I look at the data on my phone, it appears that I ran almost eight miles. I feel like I accidentally ran eight miles. I feel like the eight miles was merely a vehicle for the journey through pathways and bends and things I couldn’t see beyond. I wanted to keep running, though. I wanted to stay inside the middle of the smoothness of the curve, but my body needed to stop. And eventually I needed to turn back, go home, return to the start of today’s journey.

Often, when I ride my motorcycle and see the curve ahead, I pull back on the throttle a little harder than normal, get so close to the edge that if I reached out with the tips of my fingers and slid them along its curve, I would draw blood.

Back at home, I’m exhausted and delighted, and I drift into a restless sleep after I curl myself into a blanket and wrap myself like a burrito. For dinner I make copper river salmon and green beans and quinoa, watch a movie, sit inside a sauna and read a book by Rohinton Mistry. Sometimes it’s nice going back to where you came from. And sometimes, I realize, you simply need to re-adjust the starting point—or maybe re-adjust the perspective of the starting point.

•   •   •   •
My work partner is not quite 30, and he tells me he has been thinking about death lately. He has been thinking about the beginning of the process of the end of his life. And he has been thinking about the after-ness of death and what may or may not exist when the game is over. I think about Carlos Castaneda, about a particular book called The Eagle’s Gift, and I tell him that maybe we are just luminous orbs engaged in experience while we wait to be eaten by the Big Eagle In The Sky. This makes me grin a little—a quiet laugh inside my head, really—but he doesn’t smile, not at all, and then there is a long moment of silence—and I want, almost desperately, to know what words and thoughts are playing inside his head.

I look out the window in this silence, think about the Mayan calendar and the prediction that the world will end next year. I’m don’t care if this is true or not true, but I watch trees blow in the wind outside and ask myself: If it is true, how do you want to live, how do you want to spend this one year of your life before the inevitable end? I don’t have to think very long or very hard to answer this question, because I think like this every day that I leave my house, twist the key to lock the door and head out into the day. I wonder, often, if this will be the last time I lock my door, the last time I leave my house, the last time I will get to head out into the day.

When I get home later it is dark and cold and rainy. I have spent my day grinning and goofing off and doing things that add value to my life. I twist the key in the lock, push through into my kitchen, and there it is all at once: I’m back home, back to where I started the day’s journey.

My partner drives us back from the hospital while I sit in the passenger seat and stare—a bit absentmindedly—out the window at the mountains and the snow and the foreboding sky that is growling in the distance. I glance at my phone here and there, waiting for the weather report to appear when there is a bright flash in the sky followed by another flash and another still.

I watch the lightning, and I try to memorize the shape of the white light that flashes across the ever-darkening sky. But there is another flash just seconds later, and I am so taken by the new flash that I forget the shape of the one I have just seen. I realize, seconds later, that I can’t hear the thunder, can’t hear the rumble and the echo and the overall sound of a hammer cracking through molecules of air.

I love lightning; love the way it looks, the way it sounds, the way it makes the hair on my arms shiver when the audacity of its electricity is so close to my heart that it should become my lover.

•   •   •   •

On my way home from work, after the storm has passed and the lightning has been contained inside a magic box somewhere in the sky, I stop to talk with a friend while we drink coffee and tea and talk about things that matter and things that don’t matter and how life has this way of striking us like lightning.

I drive home in silence because I want to think about things, and I want to observe things, and I realize that wanting both of these things at once is a bit contradictory. This makes me laugh a little, and I grin all the while I start talking to myself and eventually find my way back to silence.

I love silence; love the way it feels under my skin, the way it echoes inside my ears, the way it makes my blood feel like there is a purpose for its movement.

On the way home, once the silence has become like the rhythm of my breath, I think about what it would be like to get struck by lightning, and I wonder if it would affect my heart, fix the pause that seems to never go away. And I wonder what it would feel like to have the god of thunder strike the core of my being. I wonder, too, if it would make me believe in something other than nothing when it comes to the inevitable end of my very delightful life.

•   •   •   •

There is a construction zone somewhere along the highway that forces me to slow down, and when I round a corner I see a car pulled off to the side of the road. There is a woman who is struggling to change her tire, so I stop and offer to help, and between the two of us we change her tire in a matter of minutes. After, we exchange names, simply for the sake of the moment, and we shake hands and then I climb back into my truck and start the rest of my journey home. In my rear view mirror I can see that she is cleaning off her hands, putting her tools away and getting ready to begin her journey back home, away from the city, away from her planned adventure for the day.

Later, at home, I work on an art project and read books and watch movies and find that space inside of me that—that core where a bolt of lightning would surrender itself into—and I take deep breaths, and I smile and I finish drinking a beer, finish making art, finish reading books and then I drift off into sleep. In the morning, I wake, spill myself into the day where I spend most of it goofing off as I explore parts of my city; and when my phone rings, I pause, take a deep breath, and talk with my doctor so she can tell me what is going on with my erratically skipping heart.

The cancer is back he tells me, silently, with a pushed out lower lip after I ask how the biopsy went. His lip doesn’t tremble, doesn’t waver, just simply pushes out in a sad face, as he slides a pint of Pilsner in my direction. I look at him, directly in the eye, iris-to-iris, and there is a moment of honor and respect and heart.

Chris is a bartender and also a friend. He has Acute Lymphoblastic Leukemia, which was diagnosed less than a year ago. He did eight rounds of chemotherapy, lost his job, lost his insurance and was thinking that if his cancer returned he would have years—not months—to explore the rest of his life. Instead, only six months passed and the cancer came back. It started when a lymph node in his neck started to swell. This type of cancer (A.L.L.) is aggressive, he tells me, but he’s going to do things differently this time around—he’s going to spend more time trying to heal his body and less time trying to fight his body. “If I’m going to die from this,” he tells me, “then I’m going to die from the disease not the treatment.”

Chris is 33 years old.

We talk about this for a while—for as long as I sit at the pub and drink pints and eat lunch and casually read the magazine that I brought with me while he does his job as bartender. Later, when I leave, there is a warm hug that lasts longer than a casual hug might last. I make sure that he has my phone number, make sure that he knows he can come to my house any time he wants so he can sweat inside my telephone-booth-style sauna. He needs this, he tells me, and he will call me to figure out when to come over between his hectic schedule and my not-so-hectic schedule.

•   •   •   •

When I get home, slip my key into the mailbox, I find a small padded envelope from a company in Michigan. I know what’s inside, and when I pull the envelope apart there is the clanking sound of steel hitting steel. I palm the tags in my hand, feel their weight—which doesn’t feel like much at all, which I suppose is what death would feel like once I’ve found my way into death—and close my fingers around the dullness of the steel edges.

I am holding dog tags—my dog tags—which I find odd since I’m not in the military and therefore should not need dog tags. But I am on a medical team that gets deployed to international disasters, and just a few months ago I returned from spending a couple of weeks in Haiti working in a surgical hospital after an earthquake destroyed much of their country. There has been an email thread amongst team members about why we should have dog tags and why we don’t need dog tags, and I read all of this behind a computer screen and think to myself: I should have these, not for me, but for my family (my sister, my nephew, my niece), so they have closure should something happen when I’ve been deployed on a future disaster.

•   •   •   •

I have been planning for the end of my life for some time now. I have been doing this a bit lazily, which is to say that I’ve been planning to plan for the end of my life. I tend to spend more time goofing off and less time waiting to die, which may or may not be the right path to take. While I am a teenage boy trapped inside, I am also in my early 40’s, which is to say that I should be thinking about the end of my life, especially since I’m not married (I cannot legally get married in the state of Washington, which is not to say that I would actually want to be married), nor do I have a partner with whom I want to spend the rest of my life with. So I work out the details on paper (in a Moleskin notebook), and I make plans to go to the funeral home, and I get my paperwork in order, and I fill out forms for the safety deposit box I have at my bank so that my family will have access to all of my meager assets.

I am reminded, often, of one of my patients when I think about life and death and all of those spaces in the middle. I will, for the sake of anonymity, call him Thomas. His story unfolds like this: He hitchhikes across the United States, gets caught in a snow storm, hunkers down in his tent, gets injured, is unable to get help, loses more than 100 pounds because he can’t move secondary to his injury and the snow, and he waits to die while snuggled in a sleeping bag.

Through a bit of happenstance, some hunters find Thomas even though it is early in the season. The hunters tell me they were looking for horns, and Thomas tells them where they can find some elk horns, and there are smiles all around as we pull him out of his tent and load him into an ambulance.

•   •   •   •

In the afternoon, when it is somewhat warm and mostly sunny, I fire up my scooter, pull my hands into gloves, pull back on the accelerator and wind my way to my favorite pub by way of side streets and main streets and alley ways. I slide into my favorite seat, open my magazine, settle in and watch as a delicious pint of Pilsner is placed gently in front of me. I love the color of beer—not the darker beers like Porters or Stouts—the IPA or the ESB because its caramel color feels lush and rich and unlike anything I might see when I’m walking around outside.

Sometimes, quite often really, I can feel a pause inside of my chest. This pause—this very delightful pause—seems to echo inside of my ears, seems to make me stop dead in my tracks, seems to make me stand still with eyes closed and palms outward at my side while I look into the sun or the moon or the blue sky. I stand, and I breathe, and I recall what someone once said to me: Do you want to sit around and think about it or do you want to live?

I sit at the bar and I can feel this pause through the tips of my fingers while the words of what he said resonate in my ears, in my heart. I have always known my answer, and when I turned 41 last year, I finally learned how to live my answer.

When I first meet Jefferson he is tucked inside blankets inside a cardboard box inside a tent inside a field hospital in Haiti. I am one of hundreds of people who have come to Haiti to provide medical care in the aftermath of a devastating earthquake. Our team has delivered a lot of babies, and we have seen and taken care of a lot of babies, so when I first meet Jefferson he is, to me, just another baby in a box.

I don’t know a lot about babies, and I’m generally not very good at being around babies, and I’m generally quite afraid of babies—and I joke, often, about how I might burst into flames if I have to be around children for any period of time, especially if said period of time involves the actual holding of babies—but this baby, this little baby named Jefferson changes me, and with his help I learn some very simple things: how to feed him, how to change his diapers, how to hold him. And he teaches me other things—the kinds of things I feel I have waited a lifetime to learn—about life, love, survival, death, tenderness and openness. He unlocked something, something deep, and there is some newness to me now.

For a while, at least for a few days, I don’t know his actual name, or at least no one tells me his name, which is okay because I typically call him Pumpkin. Jefferson feels tiny in my adult hands, and he is just one week old—born one week after the earthquake—and he has patches of dark hair on his head with a smidge of darkness for eyebrows and little bean sprouts of hair here and there. His parents brought him to our field hospital because he was sick, very sick, and so we have his tiny body in a make-shift baby warmer attached to wires and cords.

•   •   •   •

Our field hospital is pretty awesome and fairly similar to what I saw when I watched re-runs of MASH when I was a kid. But our hospital is a bit rudimentary in that we don’t have all the shiny tools we would have in the States. By that I mean we lack pediatric ventilators, IV warmers, baby warmers, x-ray machines and various other things. Sean Penn, however, would later arrange for us to get a digital x-ray machine, which would arrive with pediatric ventilators—and a few hundred people would smile from a few thousand miles away.

While we lack equipment, we don’t lack creativity, and we have some amazing thinkers on our team. We don’t have much of anything for babies so we have to get creative. We MacGyver things together using whatever we have on hand: knives, duct tape, string, water bottles, syringes, cardboard boxes and plastic containers. We make baby warmers, pediatric breathing masks, pediatric feeding gizmos, containers for needles, and a hodgepodge of other things.

Carol is a trauma surgeon, and she is the doctor who is responsible for Jefferson when he is first brought to our hospital. She has gray hair, is an avid reader, and has a spirit and attitude that comes with age and wisdom—the kind of spirit and attitude that I craved when I was in my 20s, and am still trying to find now that I’ve breached my 40s.

When I wake up, sometime around four o’clock in the afternoon, I find my way to where we have boxes of MREs and rifle through them looking for whatever sounds remotely good—this does not include and will not ever include “beef patty” or “imitation pork ribs.” I also hoard empty boxes for Carol, because she likes to use them as baby boxes for the many babies we would see throughout the night.

In the ICU, with the help of whoever is on staff, we fashion them into baby boxes as needed. We stuff them with paper gowns and blue chux and silver emergency blankets that crinkle and irritate my ears with each touch. The actual box is not that large, but it is wide enough and deep enough and long enough to tuck a baby inside with blankets. We take the warmers that we would use to heat our MREs and tape them inside the box to keep the babies warm, or we take one liter bags of IV solution, hang them just outside the exhaust on the generator until they turn a gross brown, but they are warm and we have piecemealed together a pretty awesome baby warmer.

•   •   •   •

Jefferson has neonate tetanus, most likely contracted from his umbilical cord in a non-sterile delivery. The prognosis for someone with neonate tetanus isn’t good. When I find my way to the ICU on this particular evening, Julie asks me to check on the baby in the box. Julie is a pediatric nurse with curly hair and an infectiously inspiring personality. She has one of those hearts, the ones that are surely made of gold, and if you give her a baby blanket and a set of sutures, she’ll whip together the best baby hat ever.

He is tucked inside one of our make-shift baby warmers, the silver emergency blanket covering his tiny frame. I pull back the top layer, find another layer, pass my hand beyond the warmed bag of IV solution and touch his little body. His temp feels good, feels warm, and he doesn’t move when I touch him, not even in the slightest. He has diapers on, and they are too big for him, and this makes me smile a little. I check the pulse oximeter taped to his toe, check his heart rate, his oxygen levels, cover him back up, this little baby in a box, and tell Julie that everything is good.

Jefferson sleeps in his baby box just one bed away from another patient with tetanus, a boy of about 16 who had to have his foot amputated when he was brought to our hospital in very bad shape: his jaw locked, his body mostly unresponsive. Not a single doctor on this deployment—and we have some awesome doctors with amazing backgrounds who work at major hospitals in major cities—has seen a patient with tetanus. Not ever. Here, in the same room, two beds apart, we have two: one tiny baby and one young man, both of who will be with us for many days.

I spend a lot of time in the ICU touching patients, calling the kids “pumpkin” and talking to them even though they are unconscious. I massage their arms, hold their hands and rub the tips of my fingers across their cheeks. And sometimes, when I am close to tears, I place the palm of my hand over their heart and say quiet words inside my head.

At night we meet for a team meeting and start the process of shift change and transferring care to the oncoming crew. We listen to everyone talk, listen to each Team Leader talk about things that are going on, and our lead doctor talks to us about Jefferson, about how we don’t have what we need to keep him alive, that this is how things go, that we need to say goodbye and that’s all there is to say about that. So we walk into the ICU—me and Julie and Carol and a handful of other folks—and we prep for shift change, and Julie sits with Jefferson and cries. I watch her from where I stand, and watching her cry while she holds his tiny frame breaks my heart.

I stand, two beds away from where I can see Julie crying, and I watch the kid with tetanus purposefully moving his hand, so I reach out to him, reach for his hand, and he grabs my hand and holds it in the way that guys shake hands. I try to hold his hand normally, the way one would shake someone’s hand, but he grabs it the other way. He hangs on tight, and when I pull my hand back, pull it toward me in release, he grabs my hand tighter and he does this every time I try to let go. He keeps me there for minutes, and I can feel tears are about to fall and I hold them back, tightly, and I hold his hand tighter and look at Julie and all the people in the room and it seems crazy and fucked up and wrong in so many ways.

Steph is one of the mental health professionals on our team. She has blond hair always pulled back in a pony tail, and she has a sense of humor like no one I have ever met before. Later, she would send email reminding us of how it is totally appropriate to run out of your tent in your skivvies after an earthquake as long as you have your helmet in hand. Steph walks up to me while I’m holding this kids hand, trying to let go and not being able to let go, and she touches me gently on the arm and asks if I’m okay. I can’t answer her. I don’t know how to answer her. I do know that if I say even one word to her I’m going to lose it, and I’m going to start crying in some endless sort of way, and I can’t do this, not here, not now, not in front of the 15 people standing in this room. But the tears come, slowly, and a few people notice this and hold my arm until I have to walk away and take a few deep breaths.

Julie pulls Jefferson out of the box, and she holds him and kisses him and several of us throughout the course of the night say goodbye to him. We hold him, this little bundle of goodness, and we don’t let go of him, not for even a second. Later, when things have slowed in the ICU and someone else is holding Jefferson, Julie decides he needs a hat, so she takes a baby blanket, measures his head, cuts a pattern and sews him a hat using sutures. She even makes the hat have a brim with a tassel on the top. This is, in my opinion, the best hat ever, but Julie will surprise me later and make an ever better hat, one with little ears on it, and this is the hat Jefferson would go home in, the one he would wear on his tiny head while his mother carried him out of our hospital while we all stood around and clapped.

•   •   •   •

Jim has speckles of gray in his shaggy hair and is one of the three-person mental health team that is with us on this journey. He is also a chaplain, and he can play guitar, and he manages to get his hands on a guitar while we’re in Haiti. He goes around to the various tents and sings with the kids, and eventually he starts a bit of a band with some of the family members who have come to see their kids. Jim and Julie sit outside the ICU and they hold Jefferson and talk and cry. I wander outside occasionally, not wanting to disturb their moment. Jim holds Jefferson close, tight like a football, and at some point I ask if I can hold Jefferson. I don’t hold newborns much, almost never have, and there is a quick moment of learning how to hold the body and the head and transfer this little package between large adult hands. I hold this tiny body in my hands and snuggle him close and whisper things into his ear and after awhile I hand him back to Jim who stays up all night and holds him.

Jefferson has what we call agonal breathing, which means it’s a bit gasping. He doesn’t breathe normally, not in any sense of what we would call normal. He breathes slowly, and with random gasping breathes, and not for a single moment in 12 hours does any one release him from their hands. Morning comes and he is still breathing, still hanging in there, and we transfer him to the day shift, and they hold him, too, never let him go without touch.

Later, after sleep, I wake up and find that Jefferson is still here. That he is eating and thriving and fighting for his life. I ask the nurse who has been watching him if I can hold him for a while, take him for a walk, and she hands him to me and asks me to promise that I will feed him. She has been feeding him pedialyte through a syringe, and I take the syringe with me, with its oddly blue colored liquid inside, and I walk Jefferson to the main area where everyone eats and gathers between shift change.

Julie is sitting there, and she smiles when she sees me walk up with Jefferson. I tell her that he is eating and if she wants to hold him again she has to promise to feed him, because I have to uphold the promise I made earlier about making sure he eats. She looks at me and thinks quickly inside her head and asks me to get her some things: a binkie, a butterfly IV, and a syringe. She takes the binkie, which has a tube running from it to a syringe, and she sticks this in Jefferson’s mouth, and he starts to suck and eat and this amazes all of us. We watch him eat and get tired and fall back asleep. Then he wakes up and does it all over again—and this delights us to no end.

Deb is a pediatric doctor, probably in her late 40s. I have dinner with her one night, and she tells me she is eating better than she has ever eaten, all the while we tear open our MREs. It’s dark out, and I’m sure she can’t see the shocked look on my face, but I ask questions about her eating habits and learn a great deal of information. Deb talks to us and tells us not to get our hopes up, not to have hope that Jefferson is going to live. But she fits him with a feeding tube—a tiny tube that goes through his nose, down his throat and into his stomach—and we feed him this way. We put a syringe on the other end of the tube and squeeze formula and pedialyte into his tiny belly.

The next day everything is different. I wake from sleeping, eat my MRE, and then find my way to Jefferson. He has developed a fever over night and this is not a good thing. He is, once again, put on death watch, which is to say this is the second time—and there will be a third time. At some point we take out his feeding tube and wait for him to go—never letting him go outside the reach of human hands—yet he doesn’t go. There is some point, some marker, at which I’m quite sure Jefferson says “fuck you!” This is the point, I think, when he starts talking. By “talking” I mean he starts crying and getting fidgety and lets us know that he is fully aware of everything that is going on.

Christine is one of the mental health people on this deployment. She is the epitome of zen and has one of those styles and attitudes that silently whispers “calm” and being around her I can’t help but be anything other than calm. She is also one of the people who refuses to put Jefferson down, and if I want to know where to find Jefferson—so I can get a little J-Time—I look for her or a handful of other people who can be seen holding him close. She has a firm belief: that the reason Jefferson continues to thrive and do well is because of touch, because we have refused to let him die in a box, sit in a box, sleep in a box—because we refuse to let him experience anything but love and touch.

•   •   •   •

Joan is tall, and whenever I look at her I think about passing her a ball so she can make the next slam dunk. She has an affection for Jefferson that goes deep, and she holds him as much as possible, and watches over him with an insanely endearing quality. When I see the two of them together she is like the mother bear protecting a cub.

I’m not sure what day it is when I wake up and stumble to the MREs, and I’m not sure how many days Jefferson has been with us at this point, but I take notes in my journal and comment on how he continues to thrive each day, on how he continues to prove us wrong. At this point he is a solid structure, the center of various hearts, and the center of a very large circle. Joan comes to find me and asks if I’ve heard about Jefferson’s latest milestone. Before she even tells me what this is, I burst into a huge grin and I think: “This kid rocks all that I have ever known.” At this point, Jefferson is nursing and he has had his first breast milk-related poop, and this is a pretty huge milestone for a kid we had put on death watch some three times now.

For the next day or two, I try to spend as much time as possible holding Jefferson. And I walk up to people like Carol or Christine or Steph and ask them if they need a little J Time, because we are all thrilled that Jefferson is doing so well that he can go home and be with his family. And there is a lot of holding and transferring of his tiny frame, and he cries each time he is shifted, each time there is movement so as to say “People! Quit moving me around! I need to sleeeeeep now!” I watch his brow furl, and his nose tighten and his mouth open, at which point his tongue does this rattlesnake type movement. And once he’s changed hands, he falls quickly back to sleep.

•   •   •   •

On the last day that our team would spend in Haiti—another team had been deployed to replace us—we find out that Jefferson is going home. This gives us closure, the kind of closure you need once you’ve become attached to someone in some way you didn’t know you were capable of becoming attached. I spend the day knowing that he is leaving, and I ignore the whole notion of him leaving all the while I spend minute after minute giving him Eskimo kisses. Soon, Joan comes to announce that Jefferson’s mother has arrived, that she is here to take her precious cargo home, and we all run to the front end of our hospital where we can say goodbye.

We line up, some dozen or more of us, along the walkway just outside of our triage area. When Jefferson’s Mom walks up with him in her arms there is an insane amount of applause and tears being held back. She looks, I might say, not quite like she understands why we are clapping. And she walks past us, slowly, through the gate with a little boy who changed a lot of people.

When I get home, back to the States, there is a clear lack of Jefferson in my life. And every moment that he crosses my world—and this is a lot of moments, an infinite amount of moments—I say outloud: Hi Pumpkin!

Haiti changed me. Being there—working in a field hospital and doing the best work of my life—changed me, altered my DNA, blurred the edges of everything I have ever known. I close my eyes here and there and think about my time there, think about everything I did, everything I saw, all the people living in a tent city just outside our makeshift hospital, and everything in my life seems like it’s spinning now that I’m home. Colors seem more rich, edges more blurred, images more granular.

Our team leaves Haiti on a chartered plane and there is applause when the wheels lift off the ground. We are given a sandwich with fresh bread and real mustard and Tillamook cheese with real wheat crackers and juice and soda, and there is silence while everyone eats ravenously and purposely. There are unspoken words, unspoken thankfulness that this isn’t pre-cooked food in a plastic pouch designed to survive the apocalypse. I ask for a soda, even though I haven’t had a soda in 12 years, but I want one for whatever reason I want one, and it is so very delicious. I drink it slowly, in sips not gulps, and I enjoy every ounce of sugar that hits the various sensory regions of my tongue. Then I fall quickly asleep and awaken before our wheels touch down in D.C., where applause rings throughout the cabin again.

We pile into a small room, all 100 or so of us, and we eat oranges and bananas and string cheese. I am too late to the meeting to get a banana, but there are plenty of oranges, and I peel mine quickly, salivating when juice squirts out of the orange and hits me in the face. I stand near Christine, offer her part of my orange, and she grabs it so quickly that it almost falls to the floor. Then someone else, someone whose name I don’t remember, runs toward us and reaches out his hand and Christine tears off a few slices from her half of the orange and he eats it so quickly that I wonder if he took time to chew.

We listen to the debriefing and talk about psychological issues, medical issues and logistics issues. We’ve seen a lot of things in Haiti that have touched nerves deep inside, and we have done things as medical professionals that we would never do in America, because we have hospitals here and sanitation and sterilization and all the right tools. We are all silent for awhile, not quite able to say anything because it is all a bit raw, and there is a moment of silence before the meeting is over and we can move on, move into the next moment of time.

After, I’m the first person to walk into the bar, order a beer and feel the cold bottle against the inside of both hands. They don’t have beer on tap, which is a little disconcerting, but I’ll take what I can get, and a cold beer regardless of name is all that I require in this moment. We drink, all of us, and cheer and clink glasses and laugh, and after a few beers we sit at tables with chairs and we eat fresh-cooked foods with flavor using actual silverware. This astonishes us, even though we have only been away from all of this for a mere two weeks.

Soon after, we eat steak and chicken and potatoes and zucchini and cheesecake, and then we go back to the bar and drink some more and eventually there are shots of liquor, which I don’t drink because I don’t drink hard alcohol or wine, and there are moments where people rib me and coerce me into drinking a shot, but I don’t succumb to the drinking of shots because I only drink beer—and I only drink light beers such as lagers and pilsners. After awhile, after the shots have gone down the hatch and people have gone to bed, Jessica and I are still standing in the bar as everything gets shut down and chairs are put onto tabletops. We have closed the bar, which is not terribly unusual for me, but it also makes sense tonight because Jessica and I have been working the night shift for the past two weeks, so we are not ready for bed, not by a long shot, so we stay awake and drink and talk and laugh and cry and hug and try to make sense of the crazy journey we just experienced. After, once the tears have mostly dried, we go to our rooms and change out of our uniforms and into our street clothes, hail a cab at 04:30 and find our way to the airport for our 06:30 flights.

•   •   •   •

When I land in Seattle I grin, slightly, because I get to take the light rail home. This is the third time I’ve been on the light rail, and the first time I’ve been on the light rail since it extended to the airport. It’s less than a mile from the light rail station to my house, and I huff my gear home all the while I’m mindful that I’m not quite stable in my shoes, not quite able to find balance no matter how hard I shift my weight or position my hips. I walk at my usual pace, a bit blurry inside my head, a bit in disbelief that I’m home, that I can take a shower every day and wash my hair, that I can flush the toilet, that I can eat something that doesn’t come in a box, that I can sleep in a bed without mosquito netting, that I can sleep with a soft pillow and wake up when my body feels it’s time to wake up. I have to train my body, too, to sleep at night and wake during the day, because I spent the last two weeks working the night shift at our makeshift hospital, which is to say that I have been working from 19:00 to 07:00

I push through the door of my house, drop the heaviest pack on the floor and gently place the other backpack nearby. It has artwork and statues and objects that I bought from people in Haiti, and I don’t want them to break. I have transported them safely this far, and I look forward to putting them on my bookshelf, in my bedroom, in the kitchen. I kick off my work boots, push them to the side, slide into my Converse and head out to eat. I need two things: beer and a salad. Climbing into my car feels weird, unusual, and listening to music feels even weirder. I start to get that feeling, the one where I crave solitude, and I sink into my aloneness with fervor.

I make my way to my second favorite pub because there will be less people there, and because the seating arrangement will make it easier for me to sit alone, because I am not at all interested in conversation or human interaction. I simply want to sit and eat and drink. I like the simplicity of this. Crave it, really. Save for the moments in the bathroom, I have spent the last two weeks around people, engaged in conversation, engaged in interaction, engaged in emotion. It is nice, really, to not have to engage, to not have to feel like I need to protect my heart. People in medicine do this, because we have to, because it is necessary. We learn how to detach or otherwise not become attached because it is easier this way, much easier.

To be honest, though, I got attached when I was in Haiti. I got very attached, and I’m not really sure how to deal with all of that now that I’m home, now that I’m physically detached from the people I became attached with, and this is all very new and very weird to me.

•   •   •   •

My skin itches sometimes. I have red bite marks on my hands, my arms, my legs, my lower back, my neck, my face—attacked by fleas while I slept in my bunk on the last night I would spend at our field hospital. Most of them don’t itch, but I absentmindedly scratch simply because the red splotches look like they should itch. I have bug bites and hives and rashes—a hodgepodge of epidermal oddities from medications and allergic reactions to medications and bugs and overall toxicity to things I have ingested and inhaled. Since I started my journey to Haiti I have taken three different anti malarial medications, steroids, antihistamines, and antibiotics. In a few months I need to get various medical tests to ensure that I don’t have some medical malady after everything I was exposed to in Haiti. Prior to departure, I had five vaccines (boosters for Hepatitis A and Hepatitis B, Tetanus, Typhoid, MMR) stabbed into both arms, both of which became sore and felt like someone punched me in the deltoid with brass knuckles.

I don’t have to go back to work for another week, and I need this week to unwind and decompress. I need to reconnect with my life here, need to figure out how to leave aspects of my old life behind, need to add all the newness of Haiti into a new life. A bunch of us talked about this in Haiti, and we are aware that coming home is going to be hard. Hard in that sense of seeing people who complain simply because they have a voice; of seeing people who feel they are entitled to everything simply because they have a pulse; of seeing people who feel they are the center of the world simply because they have walked into a room; of seeing people who feel like they are stuck when they have half a dozen choices to make. When I get home, when I sit at the bar of my favorite pub, I see this and I cringe and I think to myself: How can I be different now? How can I let go? How can I find more compassion?

•   •   •   •

I don’t tell many people that I’m home. I don’t call anyone when I land. I go home, take care of myself, try to figure out what I need, what I want in this life of mine. I think about what’s next, what matters to me, how I need to take the next steps in this journey of my very awesome life. I think about what aspects of my shell that I’ll let melt onto the sidewalk behind me and what aspects of my new shell that I’ll keep gluing together from my time in Haiti. Mostly I am learning how to walk again, how to position my body with each step so that it feels good and smooth and purposeful.

I go to my favorite pub and eat salad and drink beer and read a magazine. I get messages and phone calls and find out that I’m the only person on our team to make it home, that the rest of my team is sitting in D.C. or Newark, stuck in a snowstorm making snow angels outside their respective hotels. I think about this for a while, think about how I would be happy to be stuck in D.C., and yet I am also happy to be home in my own bed with my own pillow and my favorite beer.

I’m home now, and I get this, and I understand this, but it feels weird and almost awkward and almost not right. Working at a field hospital in Haiti awakened something inside of me, and I’m not quite sure how to move forward with this newness, but it starts to make sense when I sit at the pub and look around at people and talk to strangers and engage in conversation that matters.

Haiti changed me. And I am thankful and grateful for this moment in which I become aware of how Haiti has changed me. And I smile, and I take steps forward, and I try to figure out how to stand again, how to find balance again—and I laugh when things seem wobbly and otherwise not-right, and I step forward with my usual steadfast stance.

I get home from Haiti, sleep and rest and find my way to my favorite pub so I can drink my favorite beer. It is warm outside, and while I sit at the bar reading my magazine and drinking my Pilsner, I see a man walk through the door wearing a leather motorcycle jacket and carrying his helmet. Everything inside my head stops for a few quick seconds, and I think to myself: it’s time now, time to ride, time to get back on two wheels and open the throttle and become ever-so-aware of my own mortality.

I’m not sure how to be, now that I’m home. Everything inside my head is different, changed, altered in some blurry sort of way. I’m happy to be home, glad on so many levels, and yet there is some part of me that isn’t here right now, and I’m not sure that part of me is ever going to return.

I’m ok with that. Ok with all of this. I have spent two weeks of my life doing the best work of my life, and now that I’m home I think about how I can keep doing this, keep doing the best work of my life. I write things down, think about things, put things into motion and take steps forward.

I knew this would happen, knew this would happen a long time ago – knew that I would find the work that matters to me. I smile, more now, and I take steps toward doing more amazing work.

At home, sitting inside the plush-ness of walls and running water and electricity, I drink beer and look outside and see a tree that is sprouting buds. I think about how it is February and not time for this, and I am reminded of Jefferson and how he defied the best of medical diagnosis and went home with his mother after five days of anticipated death.

Life is awesome and funny and odd. I am thankful—almost always—for my life, and now that I’m home from Haiti, I am even more thankful for this very delightful life of mine.