Pain Is What the Patient Says It Is by David Williamson
"My father had a map of countries I thought no one knew about. In both ways, I mean. As in, I thought no one knew about the map or the countries."
The worlds this story establishes are such a marvel. One of my favorite things a short story can do — so fully and completely suck me into itself, all in the span of something so short. A magic trick, to be honest. Maybe my favorite magic trick of all.
In our interview coming next week, David talks about this story being “a convergence of two disparate interests of mine,” and tells me about his love for hospitals and his fascination for “high-church rituals, sacramentalism, the mass, etc.” And then, too, there is “the body stuff and the map and the made-up countries.” All of which I think is such a great encapsulation of what so hypnotized me about this story: the way it takes all these different interests and fascinations and builds such a singular, specific, unique world, all in a story that keeps surprising me anew with its every turn. I hope you all find it as magical as I.
—Aaron Burch
I
My father had a map of countries I thought no one knew about. In both ways, I mean. As in, I thought no one knew about the map or the countries.
The mysterious continent printed on the old paper was long and thin and bulged in the middle. If you turned the paper sideways it resembled a reclining body. The borders and names signified nothing. A wispy calligraphy noted countries and counties named Porquinas, Mertonshire, The Bulk Elgies, Mooreland Lowfield. Nonsense like that.
I had found the map in a box in our shed while looking for something else at the time, I don’t remember what. I was only a kid.
I showed my friend once.
“Looks whack,” Jordy said. He tried to smack it from my hands but missed, lost interest, and continued hanging around me so he had someone he could actively ignore.
Jordy wasn’t interested in anything except expressing wild, impossible fantasies about girls in our grade. He’d say how bored he was and how boring this neighborhood was and how he wished we could just get some weed for once and that maybe his brother could get us some.
I didn’t bother him about the map again.
I looked at the map every day for weeks. Soon, the countries on my father’s map, their names, their shapes, and jagged coastlines, possessed me. I felt their contours especially at night when I laid down and my skin hardened and cracked as it turned to dry ground plagued by the drought in Sandastradanzier. Parts of me grew soft and caved in. The crook of my left elbow turned moist and mossy, like the wetlands of Vauhgn’s Rochemier du Wamsult. By the time I fell asleep, entire parts of me had become water, salty to the taste. My fleshy landscape grew roots and produced flora nowhere found on planet Earth. Parts of me rolled with dewy hills, others peaked in craggy mountain tops. I could hear some of the countries’ names in my sleep but couldn’t pronounce them when awake. Some of the names were more like taste or texture than something I could say aloud. Other names were feelings. Deep, mysterious.
In the mornings the lay of the land reverted to skin. I’d lose it all with every sunrise, so I reproduced the map on my body with a Sharpie marker. I marked dark curves and coastlines over my soft belly, across my groin where hair had only begun to grow, along my legs, down to my toes, and back up. I inscribed some of the names of the fantastic countries and towns with a fine-tipped pen. Down my arms, across my chest, around my sides as far as I could reach, even on my face. When I ran out of room, I went into the bathroom and cut my hair as close as the electric clippers could get, then shaved the stubble down to the skin using my father’s safety razor, a thing that stayed back after he was long gone. Then, using the mirror, I wrote in the names of places on my shorn scalp.
When I was finished, I was positively terrestrial.
When my mother saw me, she screamed.
She made me bathe and rub alcohol all over to make everything vanish. The full erasure took days. It shrunk the outer layer of my skin, making it papery and tight. The markings grew faint but were still visible at first. Scrubbing had no effect, so my mother had to be okay that the boundaries and names would disappear over time, sloughed off in bits to become parts of the dust caught in shafts of light.
As the borders faded, tiny migrants flowed freely back and forth across a now boundaryless land. They tickled my skin, raised chaotic waves of goose flesh across my body. They didn’t know what was happening. Couldn’t. I erased entire continents, countless cultures, displacing indigenous peoples where they didn’t belong, say in an armpit, or behind an ear lobe.
The markings were indelible, however. Deeper than my skin. I can still feel every nation, every town, inlet, moor, lowland, dessert, crest, and thicket.
At first, I assumed my father had drawn the map himself, but now I know this was impossible. The map was too artistic. Too professional to have come from my father’s own hands and mind, which, if I remember correctly, were more tuned to the frequencies of hard machinations. Engineering, carpentry, amateur plumbing. Cartography and map making were never in his repertoire.
I wondered what use he had for it, or how he came to possess it. I wondered where he ever went off to.
II
Over the years, I accommodated my movements to the living map that was my body. Manifestations of the terrain would appear and disappear and reappear, and I learned to function well for the most part, but there was a learning curve. The first time I was intimate with a woman was quite difficult. Our topographies simply weren’t compatible.
I married a woman who either didn’t notice or pretended not to. Eventually, I hardly noticed either. We had children, I got a job, and we built a normal life by our own standards. As far as she and our children go, I’ve forgotten their names.
I had a job at a company that worked with other companies to become bigger and more successful companies. I oversaw consulting our portfolio of clients to scale and grow and become more lucrative or attractive to other companies that could potentially absorb them. I was very good at this job and worked it for years, in turn receiving promotions which led to more money for me and more money for the company and the companies we worked with.
“M&O are re-orging,” my immediate supervisor once said to me. He stood in the doorway of my office, balancing his laptop on one palm and holding a mug of tea with the other. He was younger than me, which they usually were, these bosses. He wore fitted pants and shoes that looked expensively assembled, as they were crafted specifically for him by a cobbler instead of a machine or a child or an assembly line. “Adding you to a call tomorrow morning. Need you to sidecar a reco with me. I’ll send you the deck this afternoon. Show how they can true up these new roles, so they still align with our strategy. Let’s see how it plays.”
My office had a window that looked onto West Broad Street, three stories up from a busy public bus stop. A crew of workers were repaving one of the lanes in front of the stop. I could see the steam from the new tar.
“Ok,” I said. “Send it over.”
He sent the deck that afternoon and I looked it over. Then I went home and was present with my children. One of them gave me a water-color painting of a sloth eating ice cream. The paper was stiff and rolled up like a scroll. I tacked it to the artwork board in our kitchen, using tape on each corner. I dropped a drinking glass while unloading the dishwasher, and it shattered on our tile floor. It took 10 minutes to sweep and vacuum, but I still found shards days, weeks, and months later. After my wife went to bed I stayed up for another hour and ate two grilled cheese sandwiches. Then I sat on our back porch and smoked a cigar and touched the fault lines in my neck.
III
I started taking my lunches at the hospital because I wanted to be around people who did a kind of work very different than mine. I stayed there because the hospital had become a new, three-dimensional, interactive map. One bigger and more mysterious than my father’s.
I liked seeing the people in their pastel scrubs go through the line, getting their coffees and their energy drinks and their small triangle sandwiches and plastic cups of yogurt because if they didn’t keep up their energy, they might’ve collapsed and then someone would’ve died.
Have you ever smelled a hospital? There are sections and hallways like the halls of your old school, rubber and piney, disinfectant floating up from the linoleum where it bounces the light from overhead parallels of fluorescent tubing.
The wings of new life and old life meet at a corner in this hospital. Passing from one to the other is harrowing. There’s the sweetness of milk and flowers that sharply turns thick with rancid bandages, gauze crusted over, and sour emissions from deep inside failing lungs, shriveled livers. A blockage in the kidneys.
***
There is the chapel too, where residue of frankincense has layered the marble columns, the hardwood sills that prop up abstract stained glass. There’s candle wax and smoking sulfur. Some say this is what heaven smells like. I guess a hospital would know.
At some point I took my lunch early so I could make it to the chapel by noon and watch the full ritualistic procession and performance. There were usually only a few disciples. Some, clearly employed by the hospital. Others, sojourners like me. After readings, standings, kneelings, genuflections, and recitations of holy words, I watched them take their savior onto their tongues. It was just a bit of wafer and a sip of wine, but they chewed for an impossibly long time, as if they were eating great volumes of something, breaking a thing it down, their mouths filled with food, so full that it reached back to the corners of their jaws and touched their tonsils. They swallowed great gulps of him.
I liked that the hospital was always open. People walked in at all hours of the night, clutching their chests, saying things like It hurts and I can’t breathe, simple things even a child can and does say, and these people would be taken away to get fixed. I once tried to follow them. I wanted to see what alchemy was at play. I could not get back there. The gates were locked.
I liked that the people working there did real life and death labor around the clock. It was comforting to know that there were places of work like this. Places different than mine.
The most wonderful things I saw were the teams of trained professionals, working at full capacity, moment by moment, to improve one life at a time. I imagined these celestial healers returning home, satisfied with their life choices, fully able to savor their well-earned relaxation guilt free before walking up to clock in another day.
IV
I mostly stuck to the cafeteria at first. One room with prepared foods and snacks and a short line for made-to-order hot plates du jour. The other room, a large cafeteria overlooking a garden with a large statue of the hospital’s matron protector.
“Looks like I’ll be here for a while.” I tried to look haggard and bedraggled with a coffee and a sandwich. The cashier, acquainted with second-hand sorrow, showed me empathy with only her eyes. She had much practice.
Soon my presence felt conspicuous, even in a room full of preoccupied strangers and professionals, even if only to me. Anxiety spiked with the frequency of my trips to the cafeteria. I was afraid I’d be questioned. That I would be recognized. I purchased three sets of medical scrubs from a store called Scrub Ins at the mall – aqua blue, Prussian blue, and canary yellow – and kept them in my trunk. I always put on a facemask for incognito purposes. This allowed me to travel without becoming familiar except in the most obvious way: that I was a sanctioned healthcare worker. I could only access areas that did not require badges, which, fortunately for me, covered quite a bit of the hospital. I always made sure to look busy, and so I’d bring my laptop with me, which allowed me to complete parts of my actual job for a time.
I found a discarded badge that opened new gateways for me. It was left at a seat in the corner of the cafeteria. The name on the badge, Chrissy Timbers, RN, was printed small. A pixelated headshot showed a woman with cropped, graying hair. It was a match good enough with my own hair, also cropped and graying. The badge opened doors to new territories beyond. It’s amazing how no one questions you when everyone is focused on getting real work done. I speed walked everywhere, sometimes typing away on my work-issued laptop as I walked. Sometimes with armfuls of packaged medical supplies, racing off to some phantom point of care, down the hall, around the corner, and down another hall, where I’d discard them on a cart parked outside of an exam room. My lung capacity increased, my cardio improved. I felt healthy burnings in my sides where the lands of Sugura and Petronise flanked my belly, which pleasantly shrank in the weeks to come.
I saw and heard so many things in the hospital. Emissions of blood and wild profanities. New lives emerging and older lives retreating.
I came to know most of the hospital map like the back of my hand. The restrooms on every floor, the location of maternity, oncology, and radiology. Where the surgical theater was. The chapel with its double-door entry and interior of white marble, granite statuary, dark polished wood, candle wax, colored glass, and brass. The serpentine journey to the cafeteria. Which days the young school-boyish retailer worked the gift shop, which days the older woman shaped like a cactus was on. I recognized faces. Porters and dosimetrists and other staff, but also patients and their families and loved ones. Those whose myriad trips, willing and unwilling, carved their faces in my mind to be vaguely familiar, so that if I had come across them outside of the hospital, I’d have to think long and hard from where I knew them: freshman dormitory at college, a previous neighborhood, a prom date, my child’s friend’s father, maybe a grocery attendant.
Would you believe me if I told you no one ever stopped me? No one asked anything of me?
V
First, I took extended lunches. Then multiple hours. Then half days. Eventually, I skipped full days of work. At some point I stopped going home entirely. It’s not difficult to find a bed for the night in a hospital. Most people assumed I was pulling a double shift. In a way, I really was working there. I saw so many cases come in, even if from a distance.
When I did finally go home, my wife let on that she knew I was having an affair. This wasn’t true, at least not in the way she believed. I would have argued with her, really, I would have, but all my energy was spent imagining what it would be like tomorrow when instead of going into work, I’d go back to the hospital. Breathe in its scent. Absorb all its hope and fear and urgency and recovery.
When I could no longer log in to my email, I assumed I had been fired.
Over the days, weeks, months, (years?) that I spent in the hospital, the countries of my father’s map manifested in ways that hadn’t since my youth. The plains of Krastrophoria sprouted wispy feathers of wheat and chaff along the hard planks of my shins. Shrubbery native to Onyxula sprouted and itched the sensitive skin of my underarms. Anzider’s stony peaks perforated the skin over my spine. My eyelids were marshy, the gaseous waters of Phlertong’s Cusp, rising as never before, giving me the appearance of perpetual sorrow.
If anyone observed these physiological anomalies, they never let on. A heart deep inside my bowels wept alone, without sympathy.
During one of the ancient masses in the chapel, the robed cleric quoted from his holy book a saying of his savior: “My father’s map has many countries; if that were not so, would I have told you I am going there to prepare a place for you?”
Right then, I knew all the turnings of the earth and the micro events that influenced every decision I made were funneling me to this moment where my father finally reached out in ritual. Could it be that this fabled tradesman-savior was my brother, time and space notwithstanding? The realization should have propelled me forward in ranks with the other brethren to kneel before the altar rail, but instead I remained frozen to the pew, wondering how one has the audacity to approach something so magnificent. When my window of opportunity during the service passed and all the flesh and blood were consumed or locked away in a gold-plated box, I slinked out of the chapel feeling emptied out of something now replaced with regret.
Once, I don’t know exactly when, my wife sent me an email to my personal account announcing that she had assumed I was never coming back or dead. She didn’t really care which. She couldn’t find me to serve me divorce papers, so if I ever got this email, wherever I was, just stay the hell away. There was also a note about my children and how they had her sympathies.
VI
For all my medical voyeurism, the one place I hadn’t been able to witness real work, was in the places where the realist work was happening: though the double doors and behind the curtains that required keyless entry where my badge did not allow. These were in the theaters and under the surgical lights, surgical blades.
I would say that I’d planned this next part carefully, but by then there wasn’t much planning necessary. I’d been able to observe exactly what gets a patient the attention they needed. Here’s the thing of beauty: a hospital doesn’t ignore someone in pain. Especially not in an emergency room. All I had to do was inform reception of chest pain. Chest pain gets you right into the emergency room, no bleeding out or protruding foreign objects necessary.
I did some research. I watched real footage of cardiac patients. What they suffered, what symptoms presented. I read the medical manuals left scattered in the break rooms, on the shelves. I carefully chose what symptoms I would exhibit, and which I would suppress. Chest pain put you in the front of the line. It got you on the guest list when all the tickets were sold out.
I knew I had to enter the emergency room disoriented. I had to conspicuously not know where I was or where I needed to be.
The woman behind the desk looked like she had been permanently deposited there. The woman in the next seat over appeared less adhered to her chair, bouncing in her seat and fidgeting with a stapler and a highlighter. Clicked a few keystrokes on a keyboard connected to a computer that should have been trashed and replaced years ago. She chewed gum in a sexy way if that makes sense.
I don’t know why I chose to approach the permanent non-sexy chewing receptionist with her drab facial appearances and her dreadful inertia and her joyless eyes, but I was as stuck with her as she was stuck to her post. She asked what brought me in today or how she could help me or something that sounded like what waitstaff are trained to say. I slipped her my golden ticket. “Chest pain.”
She was utterly unaffected.
She shoved a screen at me and instructed me to fill it out. I was offended. I pretended to take the screen but then doubled over. Go big or go home. I moaned and moaned. I said something that sounded like “Aayaaaugh.” I crouched to the floor and clutched the part of my chest where I thought the heart was, but who knows these days? The carpet was the color of tomato sauce vomited back up. A syrupy drool dropped from my lips. My eyes pushed against their sockets. I felt the serpentine vein in my temple surface and turn purple. I issued a constipated groan. If I had relieved myself on that floor, I’d have been thankful for the display of authenticity. I heaved my lungs to catch air and then repeated the charade. It was a demand to be seen immediately.
Two men hoisted me onto a gurney and assaulted me with all sorts of plastic tubing and arm wraps and questions. It all happened so beautifully. They were all there, at least three of them, working, getting the job done, getting me to where I needed to be.
You should have seen the lights in the ceiling. All lit, not a bulb out. Evenly paced and passing over me like a song. The team expertly navigated me down waxy hallways, pine scented and shimmering. People made way. I was crashed through double swinging doors, taken across borders, from all-access rooms to restricted, authorized-personnel-only chambers. It was like a maze to me, but it must have felt like home to them. Through all the commotion, one voice broke through the static: a high, lovely voice. One that would have belonged to an angel if I any reason to believe in angels at the time.
“Can you rate your pain, sir?” She was next to my face and keeping up with the wheels going down down down the corridors. Deeper into the heart of the hospital.
I said a letter or a color. I can’t be certain.
She provided me with a scale approximate my pain. Something industry standard. One to 10.
I said something, but I don’t know what. The pain had become so real by then. So big.
She looked disappointed. She told me that specified pain metric was usually reserved for the most excruciating of emergencies. She didn’t provide examples, so I imagined my own: victims of live burnings, unanesthetized amputations, existential despair, complete and total absence of self, etc.
It’s possible she was my first lover. The one who was crestfallen because she couldn’t find any purchase on my body, which was at the time burgeoning with exotic nature.
I hated to disappoint her for a second time, but I repeated my pain approximation, more emphatically that time, indignant even, with extra stress on the final syllable. To register my dissatisfaction, I reached back into my memory and found scholarship to provide ethos to my pain metric. I took a breath and asked, “Haven’t you ever read McCaffery?” who was a brilliant nurse and did much to vindicate patients in their relative pains. Afterall, any parents worth their salt would never tell their children, hysterical with a bloody, shredded knee, that they were overreacting.
The angelic nurse paused, and I heard murmuring. She spoke again. “No sir.”
That was the last time I heard her voice. She disappeared from my view, and I was parked in a room and replaced with another team of expert workers. In the transition, the old team offered up details of myself to the new team, details even I hadn’t known. The new team asked each other clarifying questions and answered one another with astounding specificity that I nearly fainted from the ecstasy of such efficiency and precision.
One of them, donned in sky blue, appeared to be Jordy, my childhood friend. He was masked, but I felt in my heart of hearts that it was him. I swear I heard him utter a bawdy comment. Something about a conquest of impossibly large mammary glands. Unprofessional, whatever it was.
My entire state of being was analyzed and accessed and communicated in scientific and procedural accuracy. At that moment no one on earth was the subject of a more noble profession. You wouldn’t believe the gravitas. I allowed my mind to wander to another dimension, a parallel universe when I was at my desk or at a table in a large meeting room listening to others whose blood pressures had elevated over things that weren’t even real. I stayed there long enough to feel the delight of not being there, realizing that I was here instead, and at its climax, I retreated back under the lights and teams of a more honorable profession.
I gave them answers. “Yes. Yes. No. Yes. Yesterday. I don’t know. Fourteen degrees. I work with computers and brands. Used to, I mean. Yes. No – wait – yes, now that you mention it, sometimes I do notice a lightness of the mind, an aberration in respiratory patterns, a dry cough in the evenings, and a sallowness of complexation. But as I mentioned, I used to work with computers and brands.”
Their tone shifted away from me to each other, from curious and friendly to severe and blunt. It was the same tone we used at my then-former job when we needed to deliver bad news to a client. Sometimes it felt like we had to tell them their child was dying.
They descended upon me with pinpricks and machinery. Carts were moved around, hard plastic covered my face, snakes of transparent tubing were inserted into and then taped to the marshy spot in the crook of my elbow, the floodplains of Vendervier, where they pumped fluid. The gaseous marshes filled my head with noxious and numbing vapors. The mythical Venervierian mists grew thicker than they’d ever been. I could not see a thing. Anesthesia is the vapor of the gods. I tell you because I know. I swam with them, submerged and euphoric in an absolute and palpable capital-N Nothing, but only for a little bit.
VII
The whitecoat informed me they had repaired a vital organ and that it was good that they did and that I need to be careful going forward.
“You’ll feel better, for now.”
I didn’t believe him. Bandages plastered my chest. I felt great absence. The ridges of what was once Mount Agatha was now a void. A great canyon. I tried to turn over, but the pain made me cry out. I was provided additional fluid and slipped again into the mists.
I had only one visitor. A once junior coworker, former coworker at this point, who had accompanied me on several calls with our clients. Those we vowed to grow and scale, all in service to our company’s audacious mission to change the world with reports and files and a larger market presence.
His face was still ruptured with tiny, infected abrasions. Something I vaguely remembered about him. A seeping dermatitis that had woefully continued into his adulthood. He now appeared ages older. Graying at the temples. The blemishes on his face were still there, the ones on his cheeks, covered in thick hair, once orange but now a rusty gray.
“Nobody knows you’re here but me,” he said.
I must have lost consciousness again, because when I came to, he was gone, and I haven’t seen him since. I imagine he’s growing brands left and right now, perhaps the recipient of a valuable watch and additional stock options. Good for him.
My wife, my children, my job, were far back in the distance. A past life. They had pressed on, tried to pull me with them, though I had not followed. My children turned into adults who had children, who perhaps had children of their own. Who’s to say? My wife, I imagine, is now the wife of another. Or dead. My previous job is likely obsolete and in the service of another more powerful, lucrative company. Perhaps one I had helped grow in another life. I don’t know. I never thought to check a mirror.
But my father’s map still had many countries. This was the one, sure truth. Though one place was found missing in this present terrain of my flesh, aside from Mount Agatha, and always had been. I called in the white coats and begged for the hospital cleric that was on call. The white coats acquiesced, and a man quickly appeared, dressed in black, his white collar peeking at his throat. He carried with him a small book of rituals. There was a series of questions, and through the vapors I assured him that I had been through the requisite rites to lay claim to the one I requested, though it was a lie.
He spoke holy words over me, ancient prayers that had blessed the brethren before me when they too crossed over into the land my flesh cried out for but never possessed. A new land flush with milk, honey, and fruits busting with divine nectar. A land my father ruled alongside my haloed kin.
Then the cleric offered up to my mouth the flesh of my divine brother, and the lifeblood that was once spilled but gathered up again in the ancient rites around the world, time and time again.
I took it onto my tongue and was transported to the chapel two floors below, then beyond to all the chapels the world has ever known, and into a final, perfect sanctuary without walls or windows.
I now know why it takes so long to chew. I now know what it feels like, filling my mouth, pressing against my tonsils. It didn’t taste like blood. Metallic and coppery. Like a mouthful of pennies. It didn’t taste like wine either. Rich, dark, and tart. It didn’t taste like anything you’d put in your mouth. Didn’t taste like toast or mold or linoleum or hope or fear or the papery masterpieces of so many children or any of that. It tasted like something else entirely. But I’ve finally put my finger on it. I’ll tell you what it tasted like.
If you lean in close, I’ll tell you.
STORY:
David Williamson is a writer from Richmond, VA where he lives with his family and a lot of animals. His stories have been published in X-R-A-Y, BULL, Maudlin House, HAD, Farewell Transmission and others. His screenplay, Colby, won the Virginia Screenwriting Competition, and he has an MFA from Old Dominion University.
*
ART:
Pancho Muñoz, or @greenpotion, is a mexican artist said to be born from the ashes of a cursed playstation 1 controller.
Next Tuesday, we’ll feature a bonus interview with David about this story!