Three Acts

LaVieEnRose

I recognized the name as soon as I accepted the assignment, and sure enough, when I walked into the doctor’s office there was Justin, the same guy I’d interpreted for when his...boyfriend?—whatever Evan was to him—broke his arm. Evan wasn’t here this time, or Justin’s husband, Brian. Only Justin, sitting in a waiting room and looking relatively cheerful, for someone at a doctor’s office. He looked up and smiled when I approached. Good to see you again, he said. There was a dog at his feet in a service harness who I didn't remember seeing before.

You too! I said.

I'm glad you were available, he said. I thought you did a great job at the hospital that night. This should be significantly less exciting. He reached out and scratched the dog's head. This is Martha.

What are we in for today?

Trouble breathing, he said.

Asthma? I wasn't exactly surprised, considering I'd heard plenty of labored breathing from him the last time, when he wasn't even the patient.

Among other things.

How’s Evan doing?

Something passed over his face, but after a beat he smiled at me. Arm’s all fixed up.

Good, good.

Justin and the doctor—Ramsey—were clearly familiar with each other. They greeted each other warmly and Ramsey didn’t seem at all surprised by my presence. “Always good to see you, though I’m sorry you’re not feeling well. You look good.”

I’ve gained a little weight, Justin said. Brian’s always getting me ice cream. He stopped to finger spell Brian’s name for me after using his name sign, but I told him I remembered, and he smiled.

“So what’s going on today?” Ramsey said, placing a stethoscope against Justin’s back. 

Justin coughed reflexively and then couldn’t stop, and once it had settled a bit he said, That.

Coughing?

It’s constant, Justin said. It keeps me up, it keeps Brian up. It’s been over a year now since I got sick.

Ramsey sighed. “I know. I know it’s frustrating. This is the unfortunate reality of lung scarring.”

It’s not going to get better, Justin summarized.

“At this point, I would expect that you’ve recovered as much as you’re going to.”

Justin tilted his head back and took a minute to digest this. Then he turned back to the doctor, all business, and cleared his throat. “There has to be some kind of medication that will help.”

If Ramsey was surprised to hear Justin speak out loud, he didn’t show it. “With the coughing?”

Yeah. I’m not even asking to breathe better, just to be...quieter. If there’s nothing left in my lungs that I can clear out, there’s no reason I need to be coughing this much.

“You know that cough suppressants and asthma generally don’t mix."

Neither do my allergies and literally any medication, and I still manage to take sixty pills a day, Justin said. There has to be something.

So Ramsey tapped around on his computer for a while, and then called a colleague to come in and consult with him, and then there was a small group of doctors listening to Justin breathe and going over his list of allergies and generally, from what I could see, making him nervous as hell. And the end result? There was nothing they could give him. 

Justin set his jaw and twisted his hands in his lap.

"I'm sorry," Ramsey said to him, as the other doctors cleared out.

Justin put on a smile. It's all right. I'll be fine.

**

A month later, I got a text from a scheduler at an interpreting agency I freelance for telling me they had an appointment for someone who put me down as their preferred interpreter. Always flattering when that happens, and all the better when it's someone you've enjoyed working with. Justin fit the bill.

Despite what he'd assured the doctor at the end of the last appointment, he certainly didn't look fine. I met him already in the exam room this time, where he was pale and short of breath, one arm wrapped around his waist. Evan was with him this time, frowning and holding Justin's hand in his, Martha's leash around his wrist.

But Evan smiled a little when he saw me. Thanks for coming, he said, and Justin just nodded. He was sweating a little.

Not a problem. You all right, Justin?

I'm okay, he said.

Something's wrong, Evan said. He started hurting last night and it's getting worse.

I'm going to get you some water, I said. It's not exactly in my job description, but God, look at him.

Ramsey came in soon after I got back. He sat down on his rolling stool, his face creased with concern, and touched Justin's knee. "Okay, what's going on?"

Justin took a shaky, shallow breath. I was up last night--

He couldn't breathe well, Evan cut in, then turned to me and said, Sorry. Interruptions aren't the easiest to interpret, but it was fine; I'm good at my job.

I wasn't really all the way awake, but I remember feeling something....and then when I woke up this morning it was really sore. Here, he said, gesturing towards his side.

It hurts when he breathes, Evan said.  

Justin put his hand on Evan's arm and looked at the doctor apologetically. I'm sure it's just a pulled muscle or something.

You have the highest pain tolerance of anyone I've ever met, Evan said, and I thought back to that sprained ankle at the hospital that he hadn't even noticed. It's not a pulled muscle.

Ramsey rolled up to Justin and started listening to his breathing, but Martha got up suddenly and barked once, then nudged Justin’s hand.

Damn it, Justin said. Sorry. I’m going to have a seizure.

“Do you need anything?” Ramsey said, adjusting the tilt of the table so Justin could lie down. The seizures didn’t appear to be news to him, which didn’t surprise me, the way I’d heard them talked about before. Still, I was nervous. I’d never seen a seizure before. Evan got off the table and gave Justin some space, but he kept holding his hand. Martha paced.

"I don't think so," Justin said. "We'll see." His leg and his arm started shaking a moment later, and it looked painful and frightening and kind of awful, but Justin looked relieved. "Okay, yeah, it's fine." We all just waited for it to be over. It lasted about two minutes.

How's your head? Evan asked him.

"I'm okay." It was probably hard to sign after that; his right arm was still clenched and a little twisted. "You can go ahead," he told Ramsey. "Sorry."

"Don't apologize." Ramsey put the stethoscope against Justin's back and listened to him breathe, and then he felt around Justin's ribcage. Justin was still until Ramsey hit a certain spot, when he flinched and hissed. "Sorry," Ramsey said. "I'll try to be gentle."

"I'm okay," Justin said, which I was beginning to realize he said quite a lot.

Ramsey felt around the space some more, then sat back in his stool and asked Justin if he’d been in any sort of accident lately.

“What kind of accident?” Justin said.

“Anything where there could have been some kind of trauma to your ribs. A car accident, or a fall.”

Justin watched me and shook his head.

Evan’s eyes were hard. “What’s wrong with him?”

“I need to do a chest x-ray to be sure,” he said. “But it feels like he might have cracked some ribs.”

Justin said, “How? I told you, I haven’t done anything. I’ve painted and slept and had nice, gentle, non-rib breaking sex.” I was kind of grateful I didn’t have to interpret that. Though it would have been kind of fun to figure out how to sign.

Ramsey sighed. “It is possible to break ribs from coughing.”

Justin tilted his head back and looked at the ceiling as soon as I’d signed it, but Evan did not.

“You’re telling me,” Evan said. “That he came in here asking for a way to cough less and you couldn’t give him anything, and now you’re saying he coughed so much he gave himself a serious injury?”

I signed it for Justin, who said, It’s not that serious. I’ll be okay.

Evan got off the exam table. I’m calling Brian, he said.

I went with Justin to get x-rayed, and we had just gotten back when Brian came through the door. He gave Evan a brusque kiss on the cheek and said, Let me see, to Justin as he rubbed Martha's head.

Justin pulled up the hem of his shirt, and Brian looked at the bruises on his side. His fingers were twitching, clearly itching to touch, but he didn't. 

Okay, he said, and Justin put his shirt down. Brian palmed the side of Justin's head and guided it into his chest, dropping a kiss on the top of his head. You should have told me. I was up with you.

I told you something hurt.

Yeah. I thought it was just a pulled muscle or something.

So did I.

Brian sighed, closed his eyes briefly, then turned to me. Hi. Taking care of them?

They're taking care of themselves, I said, and Brian smiled a little.

Ramsey came in soon after that and shook hands with a now very stern-faced Brian, who had his hand firmly on Justin's shoulder. He put the x-rays up for us to see and said, "Right here." 

It's broken? Brian asked.

"Cracked," Ramsey said. "Three of them, right here."

"Jesus Christ," Evan mumbled, and Brian glanced at him, then back at the doctor.

So what now? he said. You tape them up, he tries not to kill himself coughing for the next however many weeks?

Ramsey said, "We actually can't tape them up."

Brian stared. You're shitting me. You just leave him like this? He's in pain.

"We will of course prescribe him something for the pain," Ramsey said. "But the major complication of cracked ribs is that it's too painful to take deep breaths, and when the lungs aren't filled all the way, there's a possibility of developing pneumonia."

Don't say that word to him, Brian said sharply, thankfully to the doctor and not to me. Not that it would have stopped me, obviously, but it's always nice when people understand that I have to do my job, even if it's telling my client something that's going to scare the shit out of them.

Justin pulled his lower lip in between his teeth, and Evan cursed and took a few steps away from the exam table. 

Brian just watched the doctor. His lungs already don't expand all the way because of the scarring, he said. So that's going to be worse now. And he could get sick.

"It is the most common major complication from cracked ribs. And obviously given Justin's medical history it's particularly worrying."

Just checking, by medical history you do you mean his asthma, his seizures, or just the simple fact that he almost died a year ago from the same sickness you’re threatening him with now?

"Brian," Justin said softly.

No one's talking to you, Brian said without looking at him. I want to know what the plan is to keep him safe. Tell me you have one.

Ramsey took a beat, then said, "We're going to watch him very closely."

We already do that, Brian said, his teeth gritted. Justin laughed just a little and rubbed his forehead.

"And Justin, you need to focus on taking deep breaths, even if it hurts."

He can't do that, Evan said. The scarring...you’re his fucking pulmonologist, you know he can't do that.

"As deep as you can," Ramsey amended. 

Brian and Evan looked at Justin.

“Well...I guess I’ll do that then,” Justin said. He took a deep breath in, slowly, and winced a little. 

Brian watched him and shook his head.

I’ll be fine, Justin said.

**

When I saw I was the requested interpreter for an ER job early one Thursday morning, I sat on the subway and steeled myself, trying to prepare for what I was still hoping against hope wasn’t coming.

I actually saw Martha first, her paws pacing underneath the edge of a curtained-off gurney. I saw Evan then, a few feet away, arguing with a doctor. He sounded like he was holding his own, but I still waited until he glanced my way and said, Do you need me?

He shook his head. I’m fine, go wait with Justin.

So I pulled back the curtain to the cubicle. Brian and Justin were sitting on the gurney, both watching a nurse who was fiddling with Justin's IV. Justin was in a thin hospital gown with a blanket around his shoulders, shivering terribly despite Brian's arm firm around his shoulders holding him tightly into his side. He had a bulky mask over his face but was still gulping down shallow breaths, coughing so hard it would have folded him in half if Brian weren't holding him up.

Brian looked up at me, his eyes blank, and just said, "It came on really suddenly."

Where do you need me?

He looked at Justin, but he was pressing his palms into his eyes, tears pooling on the upper rim of the mask. Brian took a slow breath in and said, Just hang out in case the doctor comes back, I think. Unless Evan needs you?

He said he was okay.

Yeah, he's good at this. He scratched Justin's back absently, adjusting him so his legs were slung over one of Brian's. "Evan's pissed. They want to intubate him."

"God, really?" I looked at Justin.

Brian shrugged. "He can't breathe."

"Evan doesn't want it?"

"Justin doesn't want it," Brian corrected, holding Justin still when he started coughing again.

I nodded.

"It hurts, and it scares him..." Brian shook his head. "They have to take him away for it," he added, softly, his eyes on Justin, who was taking several tries to pull in a breath. Easy, you've got it, Brian said. Justin coughed, weakly this time, and a few tears leaked out. Brian checked the temperature of his forehead and mumbled, "Jesus," to himself before pulling Justin in tighter. 

It was awful, to put it plainly, not just to see someone that sick, but to see the entire facade he'd been keeping break down. Justin had been tirelessly telling them that it would be fine, reassuring people about his own fragility, and now he was just done. We'd used him up.

"He has a migraine," Brian said suddenly. "From the fever. That's what he's really upset about. They won't turn the lights down."

I didn't know how to say that I didn't think a migraine was his biggest problem right now, and Brian's eyes challenged me to try. And I got it; maybe the migraine didn't mean anything to the doctors, but it felt significant to Justin. And that's where Brian's loyalties lay.

Justin shivered and choked out a sob, and Brian bent over so they were making eye contact and said, We're at the hospital and they're going to take care of you. I know, I know this is hell. I know.

I want to go home, Justin said, and Brian shook his head. I can’t breathe.

I know.

I told you, Justin said with a sob. I told you it was going to happen again.

And we are going to power the fuck through it, Brian said firmly. Just like we did last time.

Justin kept crying. I’m so tired.

Brian swallowed and pulled him in closer, somehow.

Evan and the doctor came into the cubicle, and I could tell right away that Evan hadn’t been successful. He looked—well, fine compared to Justin, but pale and worn out objectively. Martha stood up immediately and guarded Justin, and Evan shook his head at her and pulled her harness gently away from the gurney.

The doctor explained, in way too many words when you’re talking to someone in respiratory distress, that Justin’s oxygen levels weren’t improving and at this point they had no choice but to intubate him.

Justin shook his head hard and looked at Brian. Tell him no, he said, shivering somehow harder. Do English.

But Brian just studied Justin, looked down at his chest and said, small, Come here. He moved Justin carefully and put his ear against his back. After a few of Justin’s labored breaths, he said “Okay,” softly and straightened up.

Tell them no, Justin said.

Brian brushed Justin’s hair off his forehead. Sweetheart. I don’t think you can do this much longer.

Yes I can.

You’re working so hard.

And then Justin started crying, really crying now, panicked gasping. Evan knelt down in front of him and put his hands on his knees while Brian gripped his shoulders and tried to get him to look at him.

I don’t want it, Justin said. I don’t want them to take me away, I don’t want to die alone.

Brian pinched the bridge of his nose and Evan rushed in and started reassuring him—both of them, really—but before he could get far in Martha barked, suddenly, and nosed at Justin’s hand. Brian and Evan quickly disentangled themselves from Justin and lay him down on the gurney, and Justin waited, his hands covering his face.

Brian said, Please let it be— and Evan nodded hard, and they were interrupted by Justin having a massive seizure, nothing like the one I’d seen in the doctor’s office. The doctor ran over to him and called for backup, and several doctors and nurses swarmed.

I expected Brian and Evan to be scared, but they breathed out and said, “Oh thank God,” in unison.

I must have looked as confused as I felt, because Evan looked at me and laughed a little and said, “He’ll sleep now. He hasn’t been able to sleep.”

The doctors got the seizure under control quickly, and Brian nodded when they turned to him. "You can intubate him now," he said. The doctors started to move, and Brian grabbed the closest one by the arm and added, "Don't hurt a hair on his fucking head."

**

I stuck around for a few hours interpreting the odd message to Evan, but otherwise just lingering around with nothing much to do, which isn't as awkward as it sounds; a lot of interpreting is just sitting on-call, waiting to be needed. 

Eventually I had to leave, though. I had another job across town that I'd agreed to weeks before. About half an hour before I had to go I left the waiting room and went to find Brian and Evan to let them know I was going, so they'd have time to make sure my replacement was ready. And to see how Justin was doing.

Evan wasn't there, but Martha was, sleeping on the floor beside Justin's bed, and Brian, in a chair at the foot of the bed with a cup of coffee held between both hands, his eyes on Justin, who was still and asleep with a small tube going into his mouth. I cleared my throat and Brian looked at me and nodded a little. "You can go if you need to," he said.

"I do, in a bit," I said. "Annie Alister is going to take over, do you know her?"

Brian said, "Yeah, we've had her. She's fine. Boys really like you, though."

"I'm glad. Where's Evan?"

"Dialysis. My kids are a mess."

I laughed a little. "How's Justin?"

"He hasn't woken up yet," Brian said. "He's pretty sedated. They said he'd probably sleep for a while." He rubbed his eyes. "It's a mindfuck not hearing him breathe. Used to it."

"Can I get you anything?"

"Not your job."

"Fuck my job for a second."

"I just wish I could do it sometimes," Brian said softly. "Not all of it, I couldn't...Justin always says it, he's right, I'd be a nightmare. But every once in a while, put me through it instead of them. Give them a damn break."

"Your part isn't easy either," I said.

"I'm just watching them. It's all I do, I sit and watch them. Pretend like there's anything I can do that will make a difference, when really it's just...one way or another, I end up back here, waiting for someone to wake up."

Brian was on-call too, I realized.

He took a sip from his cup. "I don't even know what it's like," he said. "He doesn't get one day where he doesn't have to think about what he's feeling. Just one day. I live with him and I see it in all its fucking glory and I still can't wrap my head around that part."

"You can tell how loved he is, you know," I said. "He's surrounded by it. That isn't regular."

"Loving a sick person is the deepest thing in the fucking world," Brian said flatly. "And it's also like pushing that boulder up a goddamn hill." He shook his head a little. "It's not about him being healthy or about him living as long as a normal person. It's just...you want him to feel okay. You want him to enjoy it while he's here. All of it."

"I'm not sure anyone really does that," I said. "Sick or not."

"I'm fine with him being the first." He narrowed his eyes at the bed and stood up. Justin looked the same to me, but Brian reached out and put a hand on his ankle just as Justin opened his eyes. Brian gave him a minute to look around, remember what was going on ,and then said, How are you?

Justin blinked slowly. Hurts.

Brian nodded and got up on the bed next to him, very slowly. Don't try to move, remember.

I know.

God knows how. Fever's so high I'm surprised you remember your damn name.

Tired.

Yeah, that's the drugs. And the seizure. And the pneumonia, that too.

What should we do? Justin asked, looking a little worried and a lot confused.

But Brian just gave him a little smile. We can lie here. Look up at the stars. Remember when we went on that awful camping trip?

You're mean.

Look. Brian shifted a little, facing up to the ceiling. Stars. As soon as Justin looked, though, Brian turned his gaze back to Justin, and that's where he stayed, watching Justin while he tried to find stars on the speckled hospital ceiling.

Justin noticed eventually. You're supposed to be stargazing.

Who says I'm not?

Justin's mouth twitched around the tube. Sun's a star, he said. He was starting to fall asleep again.

Yeah. Brian said. Yeah it is, Justin.