White Linen

The plastic wheel on the baby bed squeaks three times when I push it toward the window. 

It is a small sound. A loud metal click that you can still hear in your head after the wheel stops. In Room 412 of the pediatric ward the afternoon sun shines through the thick glass window of the hospital. It makes a bright yellow square of light that has no smell. Everything in Bonifacio Global City smells like nothing, or like strong cleaning liquid. 

I press the flat round silver of my stethoscope against the boy’s chest.

He is three years old. His skin is hot and sweaty, like a wet towel left in the sun. His name is Mateo. His mother sits on a plastic chair in the corner with her feet pulled up under her skirt. She has been awake since yesterday morning. She watches me with her mouth slightly open. She is waiting for me to say something that will make her stop worrying. 

Inhale. Exhale.

Under the silver disc the boy’s heart moves too fast. It sounds like a small bird trapped inside a cardboard box. 

"Good boy," I say. My voice is low. I keep my voice low because children do not like high, sharp sounds.  "Quiet now. Strong boy."

"Doktora," the mother says. Her voice is dry. A crack in the quiet of the room. "Is the fever coming back?"

"The antibiotic needs time," I tell her. I do not look up immediately. I keep my fingers on the boy’s wrist. Feeling the tiny thread of his pulse against my thumb. "We are watching him. He is safe here."

I stand up. I smooth the front of my white coat. The linen is heavy. The laundry workers in the basement made it so stiff that it feels like cardboard against my neck. It keeps its shape. It does not matter how many hours I sit on the edge of hard beds or bend over plastic baby beds. It does not wrinkle. 

I like the stiffness. It feels like a frame that keeps my skin from spilling out.

Outside the room the corridor stretches out in a long pale curve. The floor is grey linoleum with blue stripes running down the middle to guide the carts. Nurses move past me. Their rubber shoes make a steady rubbing sound on the shiny floor. 

Shh. Shh. Shh.

"Dr. Ford," Nurse Elena says as I reach the central desk. She holds out a metal clipboard. "The lab results for the girl in 405 are in. Platelets are still dropping."

"Get the second line ready," I say. I sign my name at the bottom of the chart. My signature is small and neat.  "Call the blood bank. Tell them we need two units of typed packed cells on standby. Do not wait for the evening shift."

"Yes, Doktora."

She takes the clipboard back. Her fingers touch mine for a second. Cold. The air conditioning in this building is kept at eighteen degrees to preserve the machines and keep the bacteria from multiplying in the corners. My fingers are always blue around the cuticles.

I walk to the staff lounge at the end of the hall. The glass window looks out over the tall buildings of the city. There are tall towers of steel and blue glass that look perfectly straight against the cloudy Manila sky. Below them, the streets are built in perfect squares and rectangles. There are expensive coffee shops with black metal chairs on the sidewalk. There are palm trees in pots that never grow taller because their roots are trapped in concrete. 

It is a constructed world. Safe. Clean.

I pull a paper cup from the dispenser and fill it with water from the cooler. The machine swallows a bubble of air with a loud thud.

My phone shakes in my pocket. 

I do not have to look at the screen to know who it is. The notifications from the lifestyle blogs have been coming in since noon.

I pull the device out. The screen shows a photograph from an event last night in Poblacion. The image is blurry around the edges. A snapshot taken with a flash that makes everyone look wet and white.

In the center is Scarlet.

She is laughing. Her head is tilted back so far that her long black hair touches her expensive jacket. Her hand is raised. A glass of brown liquor catching the light from a neon sign behind her. The caption underneath uses three exclamation points.

Ford Luxury Hotels VP Scarlet Ford spotted at the new rooftop opening. Manila’s favorite party girl is back after a short medical break. 

A short medical break.

That is what my mother calls the three weeks Scarlet spent in the private rooms of this exact hospital last April. That was when her heart valve started failing again. That was when she could barely breathe, and her breathing sounded like wet paper tearing. 

I delete the notification. I turn the phone face down on the laminate table.

The water in my paper cup tastes like plastic.

We are thirty-two minutes apart. I came out first. Quiet. Grey-faced. The doctor told my mother I did not cry for the first ten seconds. I only looked at the lights. Scarlet came out screaming. Red and loud and greedy for the air.

She has been screaming ever since. And everyone has been turning around to watch her.

My office down the hall is smaller than the ones given to the senior consultants. But it faces the sunrise. The desk is dark wood. It is completely empty except for a desk pad and a gold pen holder my grandfather gave me when I passed the board exams. There are no photographs on the shelves. Only green cloth-bound volumes of pediatric textbooks and three small porcelain models of human hearts showing different congenital anomalies.

The door opens without a knock.

I smell her first. Vanilla. The strong, sweet perfume she buys when she travels to Europe. It fills the room like smoke. It completely hides the smell of cleaning alcohol and clean paper. 

"You look like a nun," Scarlet says.

She drops her expensive leather bag onto my chair. She is wearing a very large, pricey suit. She is wearing dark sunglasses even though the office lights are dim. 

"You should not be here, Scarlet," I say. I do not look up from the patient log I am writing. "This hallway is only for sick people and their families. "

"I am family," she says. She pulls her sunglasses down a little. Her eyes are red, and the white parts look a bit yellow. It makes me want to test her blood to see if her liver is failing. "And technically I am a patient. My chest feels tight, Snow-white. Really tight. Like someone is sitting on it."

I look at her then. Truly look at her.

Her skin is too dry. The makeup is thick around her jawline to cover the grey shadow of exhaustion. But underneath the exhaustion there is a frantic heat. She is full of nervous energy. She always has been. 

"Sit down," I say.

"I don't want to sit down." She walks to the window. She presses her forehead against the glass. "God, BGC is so boring. Look at those people. They look like ants. Neat little ants going to their neat little offices to do their neat little things."

"Those ants pay for the rooms in your hotels, Scarlet."

She turns around. She smiles. Her teeth are very white against her dark lipstick. But the smile does not reach her eyes. The smile is just for show. 

"Our hotels, Snow. Don't be so dramatic. Papa tried to call you three times today. Why aren't you answering?"

"I was in the ICU."

"You are always in the ICU." She walks back to my desk. She picks up one of my porcelain hearts. Turning it over in her hands. Her fingernails are painted dark red, like dried blood.  "He wants you at the house on Friday. There is a dinner for the new business partners. Mom wants us to wear matching colors again. Like we’re twelve years old."

"I have a night shift on Friday."

"Cancel it."

"I do not cancel my shifts for dinners, Scarlet."

She drops the porcelain heart back onto the desk. It makes a sharp click. A tiny piece breaks off the top of the heart. A little white piece of clay sits on the dark wood. She does not notice. 

"You always do this," she says. Her voice drops. The playful tone vanishes. Leaving something thin and bitter behind. "You play the martyr. The good daughter who works twenty hours a day while I drink champagne and ruin the family name. You think you're better than me because you help the poor sick babies."

"I do not think about you at all when I am working," I say.

It is a lie.

I think about her every time I see a child with a bad heart. I think about her every time I have to tell a mother that medicine cannot fix everything. Sometimes people are just born broken, and you just have to watch them fail. 

Scarlet leans over the desk. Her face is inches from mine. I can smell the stale tobacco on her clothes. The sour hint of alcohol that her expensive perfume could not quite smother.

"Papa bought two new lots in Siargao," she whispers. Her eyes are wide. Unblinking. "We’re building a resort there. Eco-luxury. Six stars. I am in charge of opening it. I am leaving next week. “

"Your heart cannot handle the humidity there, Scarlet. Not right now."

"My heart is fine." She hits her own chest with her hand. Thump. "The doctors say I have at least two years before I need another surgery. I am going. I am going to drink all night and swim in the dark. And you are going to stay here in your stiff white coat and your clean little office, and pretend you don't wish you could come with me." 

She picks up her bag. She pulls her sunglasses back over her eyes. The mask is back on. Perfect. Unyielding.

"Don't forget Friday," she says from the door. "Mom hired a stylist. We're wearing lavender."

The door closes.

The room is silent again. But the vanilla scent stays. It gets into the air conditioning vents.It makes it hard to breathe. 

I picked up the small chipped piece of porcelain from my desk. I squeeze it between my fingers. It is sharp. It cuts into my thumb until a small drop of blood appears. 

I do not move. I do not wash it.

I only watch the red dot grow larger until it looks like a tiny bead of wax against my skin.

From the street below a car horn blows. A long impatient sound that breaks through the glass. The traffic on McKinley Parkway is getting bad. The red lights of the cars look like a slow river of fire trapped between the buildings. They are going nowhere. 

I open my drawer and put the broken piece of the heart inside. Next to my spare stethoscope and the gold pen that has no ink.

The weather outside is getting hotter. I can feel the heavy heat of Manila coming through the floor. It always finds a way inside, no matter how cold the air conditioning is. 

My phone vibrates again.

Where are you? my mother texted. Your sister says you look tired. Do not look tired on Friday. The press will be there.

I put the phone down on the desk. 

I take off my stiff white coat. I hang it on the hook behind the door. Without the heavy coat, my shoulders feel small and weak. I feel like someone who hasn't yet figured out how to survive these long, stressful days. 

I walk back out into the hall. The sunlight is gone, and the sky is turning dark grey. 

In Room 412 the boy Mateo is asleep. His mother is resting her head on the edge of his bed. She is holding tightly to his shirt, like she is afraid he will float away if she lets go. 

I stand in the doorway for a long time. I do not go in. I do not wake them.

I only listen to the sound of his breathing. Short. Wet. Steady.

It is the sound of someone who does not yet understand how hard it is to survive in this world.