The Messenger
Dr. Gold was both very well known and well liked in the hospital. It was a rare combination, and the two were scarcely ever seen together in the same person. You see most people only ever achieved one or the other around here, if ever either; being well known was only for the infamous, and being well liked only for the meek—never both at the same time. Dr. Gold, however, managed to be the sole exception. By the look of him, you never would’ve guessed either—he was quite a slovenly character. He wore a wrinkled, perpetually coffee-and-bodily-fluid-stained white coat, pinstripe button-down shirt, oversized khakis, and dirty, worn-down sneakers, the soles of which I’m sure were paper-thin. He wore a set of wiry aviator glasses, always smudged with fingerprints, and he constantly removed them to huff on and rub on his white coat. Through the top of his always-unbuttoned shirt, you could see a thick silver chain, and around his wrist, a Casio digital watch, the kind that had the calculator buttons, although I don’t think anyone had ever seen him use them. Under it all, he had a wide set frame, and a round, overstuffed abdomen. And so only about five-foot-four, he probably weighed in at around one hundred and eighty pounds if I had to take a guess—in our overheated hospital he was constantly sweating, and would rip open packets of gauze meant for patients in order to wipe the sweat off of his forehead.
He had a long aquiline nose, a balding head of gray hair, and deep, sad brown eyes—clearly Jewish, but I suspect he didn’t practice. This I only guessed because he was constantly speaking about how his children had all moved to Israel and left him, and railed vehemently against any doctor or student that wore a yarmulke in the hospital, including me. “Enough already with the kippah” he’d say, with his nasally, high-pitched voice that, funnily enough, reminded me of how my uncle used to sing Dayenu at our Passover Seder. In fact, he reminded me almost exactly of my uncle David, right down to the wiry aviator glasses and Casio calculator-watch. Never once did it seem like he was being serious with these comments, however, and actually I suspect he would’ve worn one himself had he not made such a show of the whole thing. Despite his slightly off-putting nature, he had managed to amass an army of loyalty in the hospital. There was something hard-to-describe about his demeanor, something so inconspicuously attractive that it was hard not to instantly take a liking to him on first impression and not know why—one just wanted to impress him as if he were your grandfather or close friend. And so people were always running errands for Dr. Gold in some way, shape or form. It had gotten to the point where anyone doing a favor for anyone else—whether it was covering a shift, filing paperwork, writing extra notes—when you’d ask them what they were doing, was always, either knowingly or unknowingly, working for Dr. Gold in some capacity. They would name a doctor who would name a doctor who would eventually name Dr. Gold; somewhere up in the chain of command, anything being done in the hospital could invariably trace its lineage back to Dr. Gold. He could hardly walk down the hallway without being accosted. Doctors, hospital administration, even sometimes patients themselves, were always updating him on the status of the errands they were running for him. Every day around two in the afternoon, people would line the halls of four north where he saw his patients. Of course you had to pretend like you were doing something else—everyone knew Dr. Gold rounded there at two, and so at two PM sharp, every day on four north, there just so happened to be an oddly disproportionate number of doctors checking up on their patients. It was the best time for the patients, however. But everyone else knew the real reason the doctors were there, and it wasn’t them—if you weren’t bedbound, you were there waiting for Dr. Gold to appear.
You’d think that with such an audience he’d be hesitant to keep showing up at the same place at the same time, but like clockwork, every day at two, he’d come around with his patient list and see as many doctors and staff as he would patients. He was a pain specialist, which meant that any patient with a pain, ache, or spasm too much for the average physician to handle (both in the time or effort required to treat them), would eventually end up in his hands.
The reason he was so heavily in-demand was because pain was more like a currency in our hospital than anything. Pain usually turns into complaining, complaining turns into time spent with the patient, and most of the time, time spent turns into money lost. Fortunately, there was a way to offload your patients’ complaints and escape the whole cycle for good: Dr. Gold. His patients loved him, and their doctors even more so—it was never a bad idea to consult him. Ninety-nine percent of the time he’d take the patient off your hands gladly, and only ever asked for small favors in return.
I on the other hand never really had any patients to hand off to him—I just thought he was a pleasant, kindly figure, and as a newly minted medical student just learning how hard it was to come by those qualities in the hospital, would run errands for him occasionally in my free time. Sometimes I ran and got him coffee from the café down the road, other times I handled his pager—really anything to spend more time around him instead of the other doctors.
On one of the first real autumn days of September, an awfully bright and crisp Wednesday afternoon, I was hanging around four north with everyone else waiting for Dr. Gold to show up. I had a case report to hand in to him, and was shuffling around the hallway, trying awkwardly to avoid being seen by anyone I knew, or rather, anyone I thought who may have known me. Handing in this report was the last thing I had to do that day—if I could hand it in to Dr. Gold and disappear without anyone else noticing, I would be in the free to spend the rest of the day how I liked.
The lights on this floor always flickered just infrequently and just briefly enough to mistake their malfunctioning for the blinking of an eye. And so the lights flickered, or I blinked, and there he was, walking with an uneven and heavy step that gave him away from across the hospital. In the fluorescent light that any hospital worker knows all too well, he looked acutely worn-down, more than he usually did. His white coat had more stains, his shirt more wrinkles, and his glasses foggier than ever. I couldn’t have been the only one to notice the change, because as he hobbled down the hall, the doctors lining the walls turned to avoid him completely. They must’ve guessed he wasn’t granting any favors today—they would try their luck tomorrow. I on the other hand, wasn’t so lucky.
Doctors and nurses parted from him like water rolling off an oil slick, and I was left in their wake, standing cluelessly in the direct center of the hallway. He walked directly up to me, took the paper from my hand and folded it into his white coat pocket without looking at it. “Very good. Excellent.” Not raising his head from his patient list, he paused for a brief moment. I was about to turn around and head out, already thinking about how I could spend my free afternoon when he began to speak. “Listen, instead of coming on rounds with me today, I’ve got a personal favor for you.” He spoke these words very slowly, almost as if someone else had written them down for him, and he was simply dictating them back to me.
“Of course,” I replied, turning back around and cursing myself for having been roped into doing another favor. He pulled me into room 4555 by my shoulder. One thing I liked about Dr. Gold was that he wasn’t afraid to touch people to get his point across. When he addressed you he would place his weighty, slow-moving hands on your shoulders, and you could tell immediately from their gentleness that he was being sincere.
He rested his left hand on my shoulder, cool and slightly clammy. “I’ve got a dear friend who lives a couple of miles down the road from here—” he paused, and for the first time I saw in his eyes the pain that he collected from his patients. It was one of those exceedingly rare moments in life when, looking into another’s eyes, you are reassured of the existence of others. This may just be my own finding, or I may be alone in this feeling, but it’s worth sharing nonetheless, my dear reader, if you too feel the need for the occasional reassurance. It doesn’t happen often, and when or with whom it happens we don’t get to choose—but for whatever reason, at that instant, his soul reached out to me as if extending a hand, and catching hold of mine, showed me beyond any doubt that something was there living inside of him; there was an experience taking place, one not unlike my own, there inside the person standing before me. “He’s—actually never mind what he’s got.” The patient whose room he had pulled me into, a sickly eighty-something year old, was fast asleep, and I had the fleeting thought that Dr. Gold was speaking much too loud. He seemed not to notice at all. “The point is that he’s very sick, and I also happen to be taking care of him as a friend.” It was odd hearing Dr. Gold saying that word, friend. To mostly everyone in the hospital, he was more of an idea than a real person. His image was constant and unwavering—it was more of a phrase than a name, even; it was an essence that one could evoke during conversation, and everyone would know immediately what it referred to. I tried to picture what a friend of Dr. Gold might look like, but to no avail. He carried on, “I usually take care of him at his house. The problem is that I’m too busy today to head over. I need you to go over there and just push some of his pain medication for me. Just some opiates—real quick.”
My eyes swept the room. First over at the sleeping patient, then at the open door… I hoped she couldn’t hear us from behind her veil of sleep; Dr. Gold’s request sounded extremely illegal. I wanted to ask him if he was sure this was a good idea, surely there was a nurse or caretaker to give the medication instead. But my eyes finished their appraisal of the room, and again matched Dr. Gold’s, which must’ve been fixed on me the entire time, for when our eyes me, his soul was still extending to mine in a warm embrace, as if he were trying to project as much possible emotion and life through them as possible. “I’d really like for you to go do this for me. It should take two minutes once you’re there, and when you’re done you can just head home for the day, don’t even worry about coming back.”
What could I have said? I actually considered refusing him for a brief second—Sorry Dr. Gold—I don’t know if I’m allowed to do that, actually. No, he could’ve gotten a nurse or something if he needed one; if he was requesting me specifically, it must’ve been something that only I could do. But just what was it? It felt nice to be trusted with something that mattered to him, and I wasn’t going to refuse my one and only friend in this place, but still there must’ve been someone else besides me… “Sure thing,” The words fell out of my mouth before I could think to say no, and he nodded immediately in return, pulling out a coffee-stained piece of loose leaf from his pants pocket and handing it to me. The address of the place was scribbled at the top of the paper, along with the medication and the dose I needed to give. Barely legible, I made out the words, Mr. Yischak Rubin, 102 Oak Hill Ln, Sublingual fentanyl, 900 micrograms.
He pulled out a little plastic package from his other pants pocket and stuffed it into my free hand. “It should be really easy—just put this thing under his tongue and push on the canister. Just…hold on…” he fumbled with his phone, smudging his thick fingers on the screen. “Listen—he’s a little out of it because of the pain. If he doesn’t recognize you, that’s okay. You have any questions? You’ve got my number, right?” He was halfway out the door before I could say anything in response. “Yeah, yeah, wait…” I couldn’t pull my eyes off of the sheet he had given me. I parsed the short phrase in my head over and over. Fentanyl… 900 mcg… That’s an awfully high dose... “No problem Dr. Gold. Hey are you sure about this whole—” The bulbs flickered again, or maybe I blinked, and he was gone, leaving me with the sleeping eighty-year-old, her snoring, and an incessantly beeping vitals machine, tolling away like a bell tower in the night. I looked down at the frail old woman in front of me. The machine was tolling. At least we didn’t wake her…
The sheet of paper in my hands was like a piece of holy parchment, or a hit list, rather: on it a name, address and murder weapon. An opioid one hundred times more potent than morphine, and at a dose higher than I’d ever seen prescribed in the hospital or elsewhere. But I was the hit man, whether I liked it or not, and with nothing else for me to do at this point but go, I folded the paper three or four times, slid it gently into my front pocket along with the medication, and headed out.
The fall air was a relief on my sweaty skin, and covered my whole body like drapes of cool, soft linen. It must’ve been around three or four. This early in the season the sun lazed around in the sky like it had nowhere to be, but I knew in only an our or two—and this one of the great mysteries of autumn—the sun would somehow end up crossing under the horizon before you knew it—everything, the trees, the streets, the buildings, all would be left wondering where it went in the cold and crumbly dusk.
That included me. I hopped on my bike still in my white coat and pushed off towards Oak Hill lane. I knew the street—it was about ten minutes by car, but this far upstate it was all hills, and one valley rolled into another for miles—it was going to take me thirty at least. I am an excellent cyclist however, and I don’t mind distances in the slightest. Outside of the occasional rain or snowstorm, I bike just enough every day to keep me from going insane.
Autumn is the most important time of year for a cyclist. The wind is cold enough to wick sweat without stinging your throat, and thin enough to cut through as if it weren’t there at all. At just the right angle it pushes you like a friend running with both hands planted firmly on your back. Starting gently, he begins by speed walking, but realizing that he can lean his whole body into you without toppling over himself, he begins to run top-heavy at full speed; soon you’re being pushed faster than your legs can carry, and your feet lose contact with the ground completely—the next thing you know they’re flailing in air and gravity has changed direction. Your torso falling forwards, your stomach rising into your chest… The wind is a lot like this, only now everywhere at once. And in the early fall, just as you’re getting used to the sleepy pace of late summer, it never ceases to surprise you with its voracity. Add a thin-wheeled racing bike like mine into the equation, and you can see why a cyclist like me dreams all year round about the fall; no other time will do. All year he falls asleep listening to the sound of the crunching leaves, the gentle, machine-like hum of his tires on the asphalt… but I digress…
I could talk to you forever about the ride to Mr. Yischak Rubin’s house, but I will save you the madness. In short, there wasn’t a bump or turn that slowed me down in the slightest, and I glided over the asphalt like a feathery angel speeding towards its destination. Not a single red light, pedestrian, truck got in my way—I gathered speed down every valley, and lost none of it on the way out; cool air turned to biting vortices on my skin, and I would’ve out-sped anyone if they were naïve enough to race. I wasn’t rushing either—in fact, I had time to think about my life in great detail, and all the people and things that I had met in it. For how time slows down so beautifully on a fast racing bike. I was nothing more than a beam of light, a specter, gracefully bending over every hill and turn. How I could tell you about the tears that leaked from the sides of my eyes, and how quietly they were whisked away from my face; how I thought about Dr. Gold’s reaching eyes, his reaching soul. But some moments are simply too holy to constrain in words, let us return to our story.
The rolling hills leveled out, the wind came to a halt, and I there I was coasting down Oak Hill Lane’s mottled pavement almost exactly thirty minutes after setting off. Yischak’s house was pretty and non-descript, a modest colonial with cream-colored paneling and dark blue shutters. The whole house was nestled among what I gathered to be the street’s eponymous oak trees, with just barely a few beginning to show their orange autumn outfits. I chained up my bike to a nearby tree, walked the winding stone path that led to the front door, and announced my arrival with a green brass knocker that hung at its center. A short old woman opened the door. She was wearing a long, dark green dress that fell nearly to the floor, her arms and ears were covered in old, dusky jewelry, and her face was cracked and wrinkled like an old oil painting. In fact, everything about her gave the impression that she was not a person at all, but instead a painting of a person. “Are you here from the hospital? Aaron sent you, right?” It was the first time I had ever heard anyone call Dr. Gold by his first name, and it took me a second to realize that she was even talking about Dr. Gold. The name didn’t seem to fit quite right, Aaron. Before I could answer her, however, she grabbed me by the hand and ushered me into the kitchen. “Yitzy is in a lot of pain today. Please—sit, sit.” I took a seat at a well-worn wooden table in the center of the room, and she continued on as she walked towards the stove. “Would you like some tea?” She asked, already pouring boiling water into a glass, and I stopped myself before I could refuse—I had gotten the impression already that questions were really more a formality for her than anything.
“Sorry,” I cleared my throat, “I didn’t catch your name.”
She lowered a few mint leaves into the glass, a spoonful of brown sugar, and set it down in front of me on a small dish. “I’m Anna. Yitzy is my husband.”
“Thank you,” I wrapped my stiff, cold hands around it. My whole body still ached from the cold outside. “Sorry, I don’t know what Dr. Gold told you, but I’m a medical student, he told me to come give—”
“Yes, yes, he usually comes himself. I think he said he was too busy today to come, poor thing, he’s always working himself to death. He’s usually able to make time for Yitzy, too.” I smirked at the thought of Dr. Gold having a nickname like Yitzy, but his face from earlier this afternoon resurfaced in my mind, and the sight of his sad, brown eyes tempered my smile.
Why had he sent me? And what did he have today that he couldn’t make it here? It couldn’t have been that simple. I considered the possibility that the legendary image I had of him, one that no doubt many shared, may not have been as infallible or as invincible as I thought.
Anna talked while I finished my tea. Mr. Rubin and Dr. Gold were childhood friends; but as it tends to do, life pulled them apart, and whether it was schooling or work or family, the two went a very long time without speaking. Anna didn’t recall how they re-met after all those years—she repeated several times in explaining this all to me that her memory wasn’t what it used to be. But after some time, she explained, they met again, and realized that they lived actually quite close to each other. Both Yitchak and Dr. Gold had thought that the other had forgotten them, but upon their reuniting, they found neither had in the slightest. In fact, over the next dozen or so years, they would only grow closer, in the rare way that only long-separated friends could. They spent their time telling stories from the years spent in each other’s absence, and recollecting upon a shared childhood.
Two years ago however, Mr. Rubin was diagnosed with a very rare cancer, and it put him in pain constantly. Doctors tried to treat it with all types of therapies, but nothing seemed to work. The modern miracle of medicine, as it were, only ended up causing him more suffering. He refused any further treatment—the only thing he wanted was for his pain to get back under control. But after a long string of miserable, nameless doctors, Dr. Gold was the only one he’d see, and so every day, Dr. Gold would come to carefully deliver his pain medications, of which there were several.
“You know, Yitzy wasn’t always this bad…” Anna’s voice trailed off, and she got up from her spot at the table, motioning me upstairs. From the inside, the house seemed much larger. She led me through a large hallway decorated with an endless number of portraits that crowded every available inch of wall space. It smelled like old varnish, and rays of sunlight poured in through the windows at low angles, illuminating everything in the hallway all at once. It was hard to tell where objects started and ended; where lines ceased to exist and new ones began. But Anna in her long green dress with all its wrinkles and creases led me assuredly towards Yitchak’s room, her shadow floating like a high melody over the rugs, portraits, clocks, all stacked up like perfect chords. I trailed behind, watching her shadow bend at odd angles over the many edges and vertices of the hallway, though never breaking or disappearing. All of her colors and lines blurred together in my eyes, and she looked even more now from an oil painting, one that must have been full of angels and luxurious drapes and lyres. I felt like she was too perfect for this world, like she didn’t belong with the rest of us. But she walked down the hallway towards his room all the more gracefully—she on the other hand, even if she was too perfect for it, knew she was on this earth for a reason. I had no idea what it was of course, but I knew it involved Mr. Rubin in a very great and inextricable way.
We reached his room, and Anna opened the door and let me go in ahead of her. She stopped herself, instead leaning against the doorframe behind me. It was a small room, made smaller by a huge king-sized bed at its center, covered in an even larger mount of multicolored, scraggly quilts and sheets, all no doubt knitted by Mrs. Rubin herself. Under all of it, apparently unbothered by the amount that it must have weighed, laid Mr. Rubin, a frail old man with yellowing, stretched-out skin that covered him like one of his many blankets. His eyes were shut, but wincing behind their closed lids.
“Mr. Rubin?” I rested my hand on his shoulder, trying consciously to imitate Dr. Gold. He inhaled sharply through his nose, and opened his eyes just the slightest. “Sorry to wake you. I’m from the hospital, I’m here to give you your medication.”
“Aaron? Is that you? My stomach is so awful today, just so awful…” He had a gravely voice that strained to produce each syllable.
“I’m sorry, Mr. Rubin, Dr. Gold sent me here instead today in his place, I’m a medical student. He couldn’t make it today.”
“Ugh… I need you to take me out of this Aaron—“ I tried again to tell him I wasn’t Dr. Gold, but Mrs. Rubin shook her head at me from the back of the room; I stopped myself and opened the paper Dr. Gold had given me. The words on the sheet hadn’t changed. Still the words in his poor handwriting glared back at me, Sublingual fentanyl, 900 micrograms. God help me. I pulled the little turquoise device out of my bag, and my hands shaking, unwrapped it from its innocent plastic coating.
“Aaron…” He groaned again. “Take me out of this...” I remembered the dosage chart in my head again. 900 micrograms was no doubt way too much for someone of his age—for that matter, way too much for any age. But I had double-checked with Dr. Gold, hadn’t I? Maybe he did need that much, or maybe he was tolerant somehow?
The idea of turning back flashed through my head. I could easily slip the fentanyl back into my bag, apologize profusely to Mrs. Rubin, and bike back to the hospital in just enough time to find a nurse and send them in my place. Just then, however, Yitchak’s eyelids opened just a bit more, and behind them the palest eyes I had ever seen—they were light blue—definitely blue, but almost white like a frozen lake dusted with snow. They shared nothing in common with Dr. Gold’s, in either color or depth; as much as Dr. Gold’s seemed to reach into my soul, signal that there was someone there behind them, Yitchak’s managed to convince me of the opposite. Behind his pale irises were only retinas, and behind those, a mass of fat masquerading as a person, just waiting for someone to recognize it. “Aaron…” it groaned again. A corpse had just spoken to me. My heart made its way through my chest and into my throat, and I lost my breath like I had just been punched in the stomach or dunked in ice water. I closed my eyes briefly and opened them, and started my physical exam to try and calm myself. I lowered his quilt slightly and grabbed his wrist, and immediately I felt the heat from his body that had was trapped underneath the stack of blankets. I wanted to appear as if I was doing something, and not completely lost in thought, which I was. My hands trembled on his hot skin, searching for anything that would give me a direction. Had I learned anything in medical school? I tired to picture myself back in the lecture hall, listening to my professor detail the steps of the basic physical exam, but Yitchak’s strained breathing, his sweat-tinged scent, his gently rocking body, all prevented me from leaving the room with him.
I exhaled greatly, hoping that Anna couldn’t hear me from the back of the room. Yitchak’s weak pulse was barely palpable, but it was no doubt present, slow and faint. Weak as it was, I could feel it beat rhythmically under my fingertips, and I relaxed. I lowered his shirt and placed my stethoscope on his chest, drowning out the sound of my thoughts with his steady heartbeat. I matched my breathing to his, and looked back at his corpse-like eyes, this time without frightening myself. I took to the rest of his vitals. He seemed to me, no matter how hard I tried to rid myself of the idea, truly a living corpse—from what I could tell, his body seemed to be working, only long past its expiry date. Yitchak, whoever he was, had long left it. And so there it laid, vacated and pulsing, waiting for the world to bring it to a halt.
My choice was decided for me. Why Dr. Gold had sent me was purely irrelevant. And whether or not I fully understood fully my purpose, Anna’s purpose, or Dr. Gold’s, at that very moment, I had no say in the matter—being sent was enough. I unwrapped the fentanyl device, and turned it over in my hands. I was still the hitman, only now I was convinced of my mission. My weapon was this plastic toy, and innocuous as it seemed, it was lethal. I turned the dial to 900 mcg and waited. This was nothing close to a normal dose, and I had no idea what it would do. But I had no thoughts in my mind as I rubbed my hands over the smooth plastic. I was simply the messenger, and I was at peace with the idea that I had no say in this transaction—one that in my mind now only existed between Dr. Gold and Mr. Rubin.
“I’m going to give you your medication now, Mr. Rubin, hold steady.” Listening to myself from above, the words left my mouth and hung in the air, cool and still between us. Again, I placed my left hand on his shoulder like Dr. Gold would’ve done, and pulled open Yitchak’s mouth with my right. He winced each time I made contact with his body. I looked back at Anna, who was still watching me from the doorway and who still resembled an oil painting. She was completely unaware of the transition in me that had just taken place; still she nodded her head slowly as if she knew something I didn’t.
Before I could stop myself, or think about what I was doing, I began to mouth the words of the Shema, the last words meant to be spoken before death—“Shema yisrael, adonai elohenu adonai echad.” Carefully I placed the device under his tongue, and pressed hard down on the canister. Just then his eyes grew a little paler. There was a brief hissing sound, and almost immediately following it, Yitzchak sighed greatly and his head dropped backwards onto the pillow. I pulled the plastic out of his mouth, slightly wet with his saliva, and his eyelids lowered over his eyes. His cramped, flexed body relaxed itself into its nest of bedding, and I turned to leave without waiting to hear another breath. Anna was still leaning in the doorway, and hugged me as I walked out through it. “Thank you,” she whispered, and I nodded, thanking her for the hospitality.
Outside, the sun was nowhere to be found, and the wind was blowing fallen leaves in every which way. My mind was completely blank; there was no boundary any longer between it and the quiet night air. I climbed back onto my bike, and took off in the direction of home. I started slow, barely pedaling in order to watch the trees pass by silently in their lonely, violet silhouettes. The roads were newly minted over with a smooth layer of asphalt, however, and I gathered speed; soon they were passing too quickly to see, and they all blurred together into one huge mass of branches and leaves. I lowered my body level and leaned into every turn with the whole of my weight. Before I knew it, I was once again flying over the hills with the ease and speed of an angel. The air whipped past me with an awesome speed, and my hands and ears stung from the cold—still, the only sounds I could hear were the hum of my tires and the crunching of the leaves.