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Updated: Apr 18, 2022

By Alex McAnarney Castro

There is pain.

Then there is P.A.I.N.

Then there are rivulets of blood dripping into my field of vision from somewhere that I cannot locate, intermittently covering the pinhole of post-Grand Mal confusion that allows me to glimpse out into the world. It is a small little porthole through which the outlines of a stretcher and a worried dorm counselor are all covered in a red haze.

Before this, all was darkness.

“-hit you?”

The pinhole is slowly stretched, like a gaping, heaving asshole of reality which I’m not ready to enter. It gives way to a hell of halogen lights and frigid air conditioning.

My arm lifts awkwardly to wipe some drool that feels embarrassingly chunky. Through the asshole I see: bloody chunks of teeth and lip clustered on my hand.

“-somebody hit you?”

I look at the person next to me. Something disconnected the radio. I receive but I can’t transmit. At least, I think I can’t. She nods at me. I say something. I say nothing. Nothing. I don’t know if I remember it or feel it. I’m cold.

The asshole keeps widening until I’m excreted out of my fuzzy cocoon. Someone switches on the transmission and I finally hear myself.

I hear. I am myself. I am here. I am human. I am – “Painnnn.”

I wheeze. I look down. My right hand is holding my front teeth. My left hand is holding an empty pill bottle. My shoes are off. My shoulders are shrouded in a brown EMT blanket. My mouth is dripping, and empty in the front. Fender bender.

“Fuck!” I laugh in a blood choked gurgle.

A male EMT looks at me funny. I keep laughing and trace the remaining bits of canine and fronts with my index finger. They feel like jagged stalactites hanging in anticipation of the next earthquake. Little bastards, won’t get the pleasure I try pulling out the bits with my own hands. I don’t like uneven things.

“Don’t do that!” The girl next to me bear hugs me into submission.

“I don’t see the point. Might as well go…at all this…grandma style… also, who the fuck are you?” I try to pry myself from the jaws of life. I pause.

I’m here.

“What. Happened. To. my pills?” I ask, tossing the empty pill bottle into the ground. It rolls next to the boot of one of the EMT’s.

“You took them all.”


“You said that you’d been feeling funny before you collapsed and you said you knew what it was and that all you needed was all your pills.”

I look up from the body hugging me. Her face clearly for the first time. It’s my floor’s resident advisor, Amanda. Corpulent body, fat cheeks, green eyes and pock marked forehead, I see her. My first face is beautifully human. It is amazingly there.

“I don’t even remember saying that,” I look at the bottle. A week or month’s worth of medication. “My…premiums…liver…is going to…explode...” I double forward, “My head hurts.”

I prop my head on my hands and focus on a fat boy with green hair, one of the students living in the dorms probably, but before I can understand who he is, an EMT walks and crouches in front of me and flashes a light in my eye.

“She’s coming round but we should probably take her to the hospital anyway. Falling like that, she may need a CAT scan. She may need her stomach pumped.”

I wince and read the EMT’s name tag, stretched tightly over his chest muscles. “How did I fall, Ociffer eh—Rodriguez?”

“Face first. Can’t you tell,” he responds flatly while annotating his clipboard

My body frees itself from the Amanda of life. My hand goes to my mouth. Nope, still gone.

“Oh, yeah. Stupid.”

“Most people fall backwards. That’s why we thought someone had attacked and mugged you. But you started talking a few seconds after you’d hit the pavement, according to her, and started digging in the bushes for your wallet and keys.” He points to Amanda and to the items mentioned which sit on the bench next to me. Officer Rodriguez grabs my elbow but I brush him off. He stands back amused “You ready to go?”

“It’s not the first time this shit happens. I got it.” I start to stand. My legs, a house of cards in the path of a hurricane, collapse. My ass lands right back where it rose from “I don’t got it.” I sit down. “I don’t think I can make it to work today.”

Rodriguez laughs and grabs me again. “I would recommend against it. Kid, just take the goddamn arm before you break any more goddamn teeth.”

He lifts me like a groom would a bride, but drops me on the stretcher like the sack I actually am. It’s then that I catch a glimpse of myself in the glass door. My face is mostly hamburger meat. “Que puta mierda” I mutter.

Rodriguez hears me “Well, at least Miami has good plastic surgeons.” He chuckles a little to show it was a joke. His tattooed bicep flexes, who knows if consciously. “You know I have a cousin who has epilepsy. Similar thing happened to her, but in her car. She got burned to shit. You’re lucky. You’ll be back on the dance floor, perreando the fuck out of the boys in Westchester in no time.”


A flourish from the siren on top of the ambulance wails my approach to the wrong hospital. It’s not even a hospital, it’s another school. I mistakenly gave directions to go to the University of Miami. I don’t know if I actually gave anyone directions, I just handed them my neurologist’s business card. But something is clearly amiss. The EMT’s aren’t clear if they should dump me on the side of a frat house. I suddenly remember:

“Jackson Memorial.”

“Is that where you want to go?” Rodriguez's head snaps back like a gunshot, “Why didn’t you say so before.”

I want to say You chucklefuck, do I look like I know my asshole from my mouth hole?

I may have said it.

I also repeat: “Jackson Memorial.”

A blonde woman riding with Rodriguez scratches her head and asks him in Spanish what they should do. Rodriguez responds with a yo no se. He leans over me, eclipsing the milky cast of the 6:00 AM sun.

“Kid, hey kid, where did your dad say he was picking you up?”

I don’t know when or how I called him. I didn’t think my dad was in the country. I’m actually more scared to deal with him than to deal with a potential stomach pump. I repeat:

“Jackson Memorial.”

Rodriguez swears softly and rolls me back into the ambulance. The blonde sighs and adjusts her cap. If that’s where she wants to go, she mutters in Spanish. Cuban, I should say.

“Does she know where she wanna go?” asks the driver

“Yep, Jackson.”

The driver swivels around in the front seat and looks at me from the porthole. Then he looks at the two EMT’s.

“Really? That place is a war zone!”

“Well…” the blonde gestures at me, heaving her shoulders and arms, “Her beef.”

“But the traffic!” The driver starts to complain “U.S. One is gonna be bad, boss.”

Rodriguez nods and massages his face with his hands, “Just go. It’s still early. Maybe we’ll beat the cars.”

Before we pull out, I begin to drift along the I.V.. current. I’m suspended by the waves of sleep, exhaustion, and narcotics. The siren pierces the warm water I’m sinking into again. I wonder if I can tell them to go to another hospital. Ga-dunk Ga-dunk. I’m enjoying the bumpy feeling the girders that connect concrete blocks give I-95 a little too much. Ga-dunk Ga-dunk. Rodriguez speaks into the radio. Ga-dunk Ga-dunk. The crunching and crackling interfere with my transmission. Ga-dunk Ga-dunk. Before I drift away I remember this hamster that made the same noise when it exploded in the microwave. Ga-dunk. Ga-dunk. ***

I pass into another reality. It rears her ugly head, turns away and tears herself apart, navel to mouth, birthing a squirming emptiness. When there is a space that is not like sleep, not like a drunken or morphine lapse of the brain, not like trench diving in the Pacific, not like space. When the new reality is Void. When there is no fragment of the self left. When I am not.

And then every particle suddenly bursts into hyperreal newness without continuity from before. I am an inert creature, groggy and blinded by the halogen glare of a new universe. There is no Officer Rodriguez, no pleasant sound of concrete divisions on the highway, no sexy chemicals lolling kittenishly in my veins.

It is a reality where someone screams “POLICE BRUTALITY! POLICE BRUTALITY!” into my ear in a pre-pubescent squeak. The voice comes from a face, dotted with the pus-filled constellations of youth.

I can’t say for certain anything before this existed. All I know is that a beefy, black hand presses the twelve-year-old boy into the empty stretcher next to mine, another pulls back his arm and locks him in handcuffs.

The boy’s eyes are wide, spinning plates that could break at the slightest breath. He is a wet, shivering, brown animal bleeding from a gashed forehead and he is yanked down a hallway by a huffing, overweight cop until I can’t hear the boy screaming anymore.

I blink. Nothing more to be done. I try scratching my nose with my right hand. But it won’t budge.

Then I realize I too am handcuffed. To my stretcher.

“Excuse me. Excuse...Excuse me!” I muster all the suburban outrage I can.

“I’m right here.” The voice of God speaks from above. I tilt my head up and backwards. God is a pudgy Cuban woman—More Cubans?—with kitten-printed scrubs.

“Excuse me. I’m sorry, but what the fuck?” I point to the handcuffs with my left hand.

“I’ll tell the officer to let you go. We didn’t want you to be a risk”

“Did I hurt myself with another seizure?”

“No, not at all,” she smiles as she starts walking away

“Well, so what was it?”

“Oh, well, we didn’t want you to leave without getting your ID and insurance,” she smiles and sets my chart down on my blanketed shins, “You do have ID and insurance, yes?”

“Me esta jodiendo? What does that have to do with being treated like Rodney King Jr. over there?” I gesture to the hallway through which the police-beleaguered boy has disappeared.

The nurse is surprised, but not at my comment.

“Hablas español?”

“Doesn’t everyone in this stupid city?”

“No parece.” As expected, she drops her polished veneer of professionalism once her language barrier is breached and holds my hand like an aunt, “Pobrecita, your poor face. I kept saying to myself, poor thing, she’s so pretty and now she can’t smile. A girl without a smile is like a knife without a sharp blade.”

I look into the white halogens above me. Nothingness, swarm me please. “I don’t know what that means. Please take this off.”

“I’ll get the officer. You seem awake enough. Ahorita vuelvo.”

I keep staring at the halogen lights. Pretty. Pretty. I run my tongue across what’s left and my free hand on the pavement burns scouring my chin. Pretty. Of all my half-baked pursuits of my life till now, I can’t recall “Pretty” being one of them. Now it never can be. Shame. My nose itches again. I lift my right hand only to have it yanked back by the cuffs. Administrative Brutality. At least I’m still funny. Ish.

I turn my head for a brighter view. Waiting. Scurrying. Lobbying. It is an endless forest of defoliating bodies, the moans carried up into the current of the frigid air of the E.R. like trees in winter. A bloody sunrise over a snowy hill glimmering with treasure or a lacerated thigh with a piece of car window sticking out of white gauze. Images run together in my half sleep, half-awake state. “Pretty,” I mutter as I burrow as deep as I can under the blankets.

They’re not as starchy and thin as books say they are. This is quite warm and fluffy. I wonder how many people have pissed, shat, vomited, overdosed and died inside my cocoon. Maybe souls make like Downy and add a poofy dash of spring scent to the ER room linens. Maybe the blanket has had the death washed out of it so many times during the past 48 hours that all starchiness finally capitulated to the power of Maytag. Maybe I will disappear into the fibers and clothe the next Spaz that thinks it’s a good idea to wake up at 4:00 AM to pick up a friend at the airport.

I burrow deeper. I know where I belong. The stalactites dig down into my flayed lip.

I hear a scuffle outside and peep out from the sheets.

Three or four rows down, I see a sweaty, brown man. He is short. His baggy shorts drag on the floor and he is leaning heavily against an old man’s stretcher. His weight is moving the bed into another patient’s, a very fat female -Ms. Piggy- who starts to squeal the second her beady eyes open from their morphine induced haze.

“What are you doing? What are you doing? What are you doing?” her shrill squeals filter down the ER.

The man doesn’t respond, he places his forearm down on the stretcher and looks up at the halogen lights. Two thin seams of blood trickle from his ears.

“What are you doing? What are you doing? What are you doing?” the whining metonymic squeak continues.

“Holy shit!” I mutter. I burrow deeper. I know what happens next. Every zombie movie I’ve ever seen has taught me so. A war zone indeed.

Except that instead of tearing Ms. Piggy’s throat out with his yellow teeth, the man starts singing, his head tilts back and he as he belts out, not the unfathomable gargled notes of the undead, but

“Is he singing?” A nurse standing next to me peers into the cave of my blankets.


“What is it?”

I draw the blanket around me “I don’t know. I don’t care. Be a nurse and stop him.”

Through the sheet I can make out her shape, outlined by the halogen lights. The entire ER is paralyzed. Only the man, belting out his clear “Ah!” in mezzo, alto, basso like a warm-up exercise before a recital. Then a crash followed by screaming. I open up the white cocoon. The man collapses in a bloody pool that progressively gets bigger. Most of the blood is coming from his ears and mouth. He fell face first, too. I giggle.

“Go get a doctor! I swear, this only ever happens in Miami…” The nurse who had so rudely interrupted my self-pity has finally moved. A group of orderlies crowd around the man to turn him over. The fat woman whose stretcher he had been leaning against pulls the covers to her chin and continues repeating “What are you doing? What are you doing? What are you doing?” Only now in a whisper. I can’t see his face, but I know that he’s unconscious. They carry him to another section of the ER where I can’t see him.

It could have been anything, Ebola, SuperAIDS, Anthrax, Botulism—I feel a warm clamminess pressing on my shoulder. It’s come to claim me, the world of the infirm and the decaying. I scream on the inside and constrict myself into a tighter ball underneath the sheet.

“Sweetie? Snookems?” It’s the weathered voice of the blue-collared beyond. I uncurl and emerge from the cocoon.

“Hi Dad.”

“Oh, kiddo. Let me see the damage…”

I smile like only a princess can smile for her daddy. He winces.

“I kept bouncing from hospital to hospital, you weren’t very clear,” he reaches out, but not for a hug. He pokes the big scrape on my chin making me flinch.

“I don’t remember calling you, even,” I mutter and start to pull the sheets up again. The voice of my reaper is annoyed, tired, and reeking of whiskey and Benson & Hedges.

After confirmation from the front desk that the bill will be sent to my Dad’s address, I’m told, old man sigh after old man sigh, that my mouth will be fixed and my brain will be re-wired. But I will need to be strong. I am then told to straighten up to get to the parking lot.

But we realize I’m still handcuffed

The nurse apologizes, unlocks the handcuffs. She doesn’t seem to like my dad much and pats on head. Cuidate, she says, as she walks away down the hallways.

I pull myself up by my fraying converse shoe-laces and I clamber onto my Dad’s 57 year old back. It’s about 200 meters before I collapse into the leather passenger seat, inhaling the deeply ingrained scent of Red Label and those damn Benson & Hedges cigarettes.

“I hadn’t done that since you were nine,” he pants like an old wolfhound in the doldrums of summer. The lines on his weathered leather face keep moving.

Poor bastard can’t deal with this, I think, blinded and deafened by the Little Havanascape unfolding on 12th Ave. Miraculously, there are few cars heading South by the time we hit US 1.

“—stop at Walgreens before we get home to get you what the nurse prescribed for the pain,” the lines stop moving long enough for them to pucker and take a drag of a cigarette, his seventh in two hours.

I nod and roll down the window letting my head hang out in the peaty humidity where I can sometimes catch a whiff baking bread, diesel fumes, cilantro, and the cigarette smoke coming from inside the car. The a/c is blasted on full but Dad doesn’t make me roll up the window. The lines on his face are still moving.

“—gets here in five weeks. It’s the best she could do.”

Mommy is coming to take care of the baby. Apparently, I called her right after. I wonder who else I called and what I said. Or who I should have called and gotten away with telling them things I never would have said otherwise.

My head remains half-hanging outside the window. I only think to say

“Dad, what the fuck, you smell like an airport lounge and it’s only 8 a.m.”

He finally laughs-wheezes and pats my shoulder.

“Don’t fucking swear and you should know, it’s a little past noon, kid.”


We stop at Walgreens. By the time we drive down the antiseptic placidity of Pinecrest and into his driveway, it’s noon. I would be hungry but the challenge of eating without front teeth makes me feel even more tired. I shuffle up the front steps and into my bedroom and collapse on the feathered down comforter, sinking into the darkness.

Dad comes in with the Walgreens bag and puts the painkilling contents on my nig