He might has well have shot me, sending that note. Or at least that’s how my health sensors reacted, blaring up at once like an unholy chorus. Cortisol alerts, stress infractions, the beeping alarm of my heart rate rising without the expected stimulus of exercise.
“God damnit, Shen,” I muttered, silencing the alarms but unable to turn off the insistent buzz on my wrist. With his letter crumpled in one fist, I flicked a look down at the screen of my BioMonitor.
UHD Alert – Ms. Numa Faraq, you appear to be having some sudden-onset distress. Please provide urine and saliva immediately for further diagnosis.
Was that intentional? Did Shen suspect, perhaps, his ironic symmetry?
As if in silent rebellion, I followed the instructions on my watch, trying to focus on my breathing as I spat and peed into the chrome diagnostic-toilet I was just beginning to get used to. It whirred under my thighs, analyzing its trophies like a god weighing mortal offerings on an ancient altar.
But not loudly enough to distract me from the folded paper on my lap, the letter he’d slid under my door.
How dare he? How dare he insert himself back into my life while I’m moving on, embracing what he’d chosen to reject? That pretentious, arrogant, irresponsible…
As if in agreement, my BioMonitor beeped. I glanced down.
UHD Alert – Ms. Numa Faraq, your saliva and urine show high levels of cortisol. A friendly reminder: stress is detrimental to bodily function and is considered a preventable health threat by the Universal Health Directive. The fine for Prolonged Emotional Negligence is $300 with potential for disciplinary action. Please think responsibly. We advise you to reach out to your social contacts for support, such as:
My lips twitched with sardonic bleakness, knowing the little machine on my wrist had no idea how very un-relaxing it would be to call Mom. But I could hardly blame it. There was no one else to offer. Clenching my jaw with aching force, I tried not to think of the other names that were no longer on that list. Dad. Sandra.
Don’t think about it, I told myself, climbing into the shower. I stayed for them. For all the fathers and friends and lovers I can still save.
“Doesn’t he realize that?” I said aloud, the words burbling through the clear rivulets coursing down my face.
The only answer I got was a cheerful beep from the weight-sensing tiles, confirming that my BMI remained a healthy 21.1. A little avatar winked on my BioMonitor, offering me a thumbs-up.
You’re an anti-obesity champion! said the alert as the avatar continued to smile. Keep up the good work!
Diabetes: Their tireless work unappreciated, exhausted β-cells begin to shirk their duty. Or maybe the insulin receptors, like overstimulated children, cover their ears and hum over the fists pounding at the door. Ignored, unwanted, the glucose that should have been squirreled away for winter drifts through the blood, looking for a home. A safe haven. It will find one in the heart or the arteries, maybe the liver or the warm den of the pancreas. The kidneys will pump, frantic and maternal as they fight to clean up this mess. But what can they do against the onslaught of nutrients, the suffocating abundance? Ignorant of the ravaging wildfire inside, the owner of this straining factory eats on…
My smug first-year resident didn’t — couldn’t — realize that it wasn’t a lack of sleep that made his attending’s eyes look so distant. But I snapped back to attention quickly, with all the cultivated rigor of medical training. The patients come first, I reminded myself.
“Tell me about this one,” I said, jerking my chin to the sleeping woman sprouting a root system of IV lines and drains.
“Textbook case.” The young man shrugged without sympathy. “Necrotizing fasciitis, caused by a Group A Strep. Apparently, she got it from her ski glove of all things. Poor lady had a paper cut on her finger and the infection traveled up her arm to settle in her abdominal cavity.” He shook his head with a disbelieving grin. “The ER team said she was lucky her BioMonitor caught the infection, or else she’d be toast.”
“The pathology report?” I asked.
“Nothing complicated. Gram positive, catalase negative.”
“What treatment do we have her on?”
He pointed to the bandages packed onto her middle, oozing pus around the edges. “Well they sent her through surgery to remove the necrotic tissue.” He said this with a well duh kind of expression that made me want to put him on bedpan duty. “The machines seem to have gotten it all. And now we’ve got her on an antibiotic combo. Vancomycin and penicillin G.”
I watched his answer, looking for a flicker, a blown candle of human empathy. He shrugged again.
“Dr. Hansen estimates a 75% chance of survival, but I don’t think it’s that high.” Then his smile turned conspiratorial. He leaned in. “That UHD officer has been sniffing around all morning, but this patient won’t be waking up to any fines. No way could she have prevented strep from growing in her glove.”
I frowned back, feeling blurred around the edges as I thought about the streps in all our gloves. The bumpers with our names on them. The bullets we can’t see coming.
What’s so wrong with side-stepping the ones we can?
But of course, Shen wasn’t there to answer. So I turned to the young doctor, trying not to think about how his arrogance felt so brutally familiar.
“And the ChemBalance patient?” I asked, clacking down the ICU in my heavy, utilitarian clogs.
“Oh him,” the resident winced. “He’s not happy.”
“I don’t imagine he is,” I said.
But that’s not the point.
Do you remember when we met? You offered me a greasy plate of homemade donuts and a cigarette-stained smile. Did you know — I’ll bet you didn’t — that my father had just died, strangled from the inside by telescoping arteries closing against his life? Did you know that every day I watched helplessly as my patients smoked and ate and worried themselves to death? You didn’t look at all concerned when I said no. If I’d known you better, I wouldn’t have been surprised. But when I left Sandra’s party, I was determined to never see those charming eyes again.
I guess I lost that war.
“Mr. Thomas, how are you feeling today?” I asked, stepping up to the end of the oversized hospital bed. Even at six-five, the man lounging there looked small and shrunken. Huge shoulders curved protectively over a wide barrel of chest, more used to clean-cut suits than thin hospital gowns. He peered at me owlishly, like something from the back of a cave. So instead, I turned to his wife. “How’s he adjusting?”
Her eyes glistened, oily with regret. “He… doesn’t love it.”
I forced my features into an understanding smile.
“I hear there’s an adjustment period, but give the implant a few days to calibrate your chemical balance. You’ll be stable in no time, sir.”
“How would you know?” His voice came out in a growl, antagonistic and raw. “You goddamn doctors don’t know anything.”
My smile stayed hitched in place, a road sign swinging in the wind.
“Well, I know that you’ve been suffering from high levels of anxiety and depression. I know that your neurotransmitters weren’t being produced and distributed properly, as per your BioMonitor. And I know that our new ChemBalance is designed to help brains like yours stay healthy.”
His lip curled in a pale imitation of what was probably once an intimidating business sneer. “Just because I didn’t pay my UHD fines doesn’t mean you had the right to screw around in my head.”
Actually, that’s exactly what the new law says.
But no, not now.
I swallowed the antagonistic urge to vent my frustrations on this patient, this ignorant man who had no idea what I was dealing with, what I was going through. Instead, I said, “Mr. Thomas, the UHD was designed for the well-being of our citizens. Your habits — driven primarily by a dysfunctional neurology — were going to make you sick and that would have made you a burden on society. So the health officer in charge of your case decided that this operation was the best option.”
His glower didn’t waver under my determined kindness, so I turned to his wife.
“We’ll give him another day to adjust before sending him home. Please let us know if you need anything.”
Then I left them alone, drilling my gaze into my clipboard as I walked back down the ward, trying not to think about those eyes, that hate. Should I have told him that I’m on the wait list for the same procedure? That someday soon I would also join the ranks of the forcibly balanced, the chemically sane?
As if summoned, Shen’s letter swam into my mind. I could recite it word-for-word despite the fact that I had shoved it down the garbage disposal. One line remained etched on the inside of my eyelids, pulsing with violent austerity.
Numa, don’t do it. Don’t make that choice.
Fuck you, I thought helplessly. When did you ever understand anything about healthcare?
When did you ever understand anything about me?
Cancer: With every stress and sunburn, another base pair bends. Cracks. Fractures. The genetic ladder fights to stay straight, but replication proteins zoom over the damage perilously fast. They must. The body demands new soldiers to defend the bulwark of the stomach, the abused fortress of the skin. But then a traitor, black and toxic, sneaks into the fresh recruits. Mostly, your imperious immunocytes catch the mutineer and perform the necessary execution. But sometimes this malevolent spy sneaks past your defenses with its broken promises, disappears into a shaded, unnoticed corner.
I knocked gently on the door, right under the plaque that read Chief of Neurology.
“You called for me?”
Dr. Federica Vasquez had eyes that could flay skin from bone, black hair framing her face in scalpel-sharp lines. She was short, but somehow dominating, even more so after she volunteered to be one of the first to join the ChemBalance trials.
Now she was looking at me with a level, calculating expression that hasn’t suffered a mood swing in over a year.
“Dr. Faraq, please sit.” She flicked a hand at the one chair in the room besides her own, snapping her attention back to her computer. Settling in the uncomfortable palm of the wooden seat, I tried not to feel like a schoolchild waiting for a scolding as she finished drafting an email. I passed the time by examining the framed awards that cluttered one wall, from the city, the state, and even the President himself.
Look, I told myself in strict reminder. This is the woman I want to be. She’s a general fighting the battles that matter. This is why I stayed.
Finally, she turned to face me.
“You’ve been approved for the procedure,” she said without preamble. “Tomorrow, nine a.m. sharp.”
My breath caught traitorously, like the squeal of a reed instrument, and I couldn’t help thinking about that stupid goddamn letter rotting in the pipes of my apartment building.
Did he know? Is this why he chose today, of all days, to write?
Dr. Vasquez squinted at me, her raptor gaze missing nothing.
“If you’re not ready, there are other people who —”
“No, no,” I interrupted. “I’m ready.”
But this woman who watched me evolve from a frightened graduate from rural Vermont to a native New York City doctor knew me too well to miss the pulse of hesitation, the thrum of unease. She leaned across the mahogany desk, her sharp mouth softening so imperceptibly that a less-trained eye than mine would have missed it.
“You’ve had a hard year, Numa. It would be wrong to say that I understand, because I don’t. But I can imagine how difficult it’s been for you.”
I forced my cheeks to pull up, fishhooking a smile.
“We’ve all had a hard year. But the UHD is working. Things are starting to settle as they should.”
“So it seems,” Dr. Vasquez said. “But that’s not what I meant.”
“I’ll be fine.” I folded my hands in my lap, squeezing them together like they’re cells that might renege on their dividing, that might push back into a single unit. “I just need to keep moving forward.”
“And you’re talking to someone? To… cope?”
It was her duty to ask, but I was grateful all the same. I pushed to my feet.
“Who has time for that?” I said, letting half of my dragging smile fall.
And she nodded, not with humor but not quite with pity either.
You were so handsome when I came to bail you out. I was still in my running clothes with sweat trailing its ticklish fingers down my spine. You grinned at me as if it was nothing, but I was so furious. I could have killed you right in that park outside the police station if I didn’t want to kiss the blood off your lip. Because there I was, pulling long nights trying to build something while you were protesting to break it down. You refused to wear your BioMonitor despite the fine notices building up like snowdrifts around our apartment. And even after my father’s funeral, you smoked those fucking cigarettes and told me that you didn’t care if they were clogging your pipes because you weren’t just living. No, you were ‘enjoying your life’. You said you wanted nothing to do with this new world. I said that meant you wanted nothing to do with me.
I didn’t realize you’d call my bluff.
Dr. Vasquez ordered me to take the afternoon off. She reminded me that it was still my choice to get the ChemBalance installed. After all, I had no outstanding fines and my depression was under control. I wasn’t like Sandra used to be, elbow-deep in misdemeanors and sarcasm. Even as a resident, she could never bring herself to prioritize health over enjoyment, well-being over fun. Maybe that’s why she and Shen were friends. Maybe that’s why she introduced us, because she thought he’d be good for me.
Well, you were wrong, Sandra, I snarl to myself as I march out of the hospital, slinging my messenger bag over one shoulder with enough force to bruise the muscles around my spine. Look at me now, lost in a sea of imbalanced neurotransmitters and bad sleep habits. And it’s your fault. You brought Shen into my life and then you left me here alone to deal with it, all because you couldn’t stop taking those stupid pills.
Could the ChemBalance knit together a soul as shattered as mine?
Only one way to find out.
I stood on the sidewalk, squinting under the sun’s assault and remembering the last time I saw Sandra alive. We were in the locker room, changing out of our surgery scrubs and laughing about how much she owed me for all the coffees I’d been buying her, for the lunches I’d picked up when she ducked out of the cafeteria to avoid the hospital’s UHD officer.
I knew my dad would have been the same.
But if he’d lived long enough for our new world to save him, would he have learned to change?
Coronary Artery Disease: Blood runs thick and sludgy through narrowing canals, opaque with smoke particulates, or maybe cortisol. Lipids, bent and polarized by their crowded journey, latch onto cell walls like frightened sailors grasping for shore. In these quick-moving rapids, they reach for their friends, for strength in numbers, rising into funerial mounds of calcified protection. The blood must pulse harder, slowed as it is through this manufactured choke point. And in the resultant quagmire, fatty chains have more time to latch, more time to harden, more time to reach for their brethren. Join us, they croon to their fellows. Join us in congress for the time we have left.
It was amazing to me how much Manhattan had changed since the UHD’s launch became official. In my walk home from the hospital, through that familiar and endless corridor between skyscrapers, a different kind of cloud hung over this new city, a polar opposite of the heavy smog we all used to breathe. Spattered among the ads for shoes, shows, fashion, sex, were huge billboards promoting new BioMonitors and mandatory sensing equipment (Just because you have to wear one doesn’t mean it has to be ugly). Notices ran like tickertapes over screens that used to show stock prices or headlines (UHD Reminder – Random checks are in effect. Make healthy choices and you have nothing to fear). Everywhere were the signs of a nation coalescing under one purpose, under one united mission.
You’re better than a burden.
I stared at the UHD slogan painted in huge red letters above the Macy’s in Herald Square. Sandra had cackled with laughter when it first started showing up, calling it ‘corny as all hell.’ But I hadn’t. I still didn’t.
A commotion started across the street, sharpening into a high-pitched wail. I swayed, dragged suddenly back to the present as I watched two UHD officers loom over a woman with bloodshot eyes.
“I can’t pay that!” she screamed drunkenly as savvy New Yorkers skirted the scene like water around stone. “I’m already in debt!”
“Then I’m afraid we’ll have to take you in, ma’am,” said the larger of the two officers, his gun dark and ominous on his hip.
That had been one of our biggest fights, before Shen left. In the twilight of that tenth-story apartment, we’d stood on opposite sides of our shared living room, volleying opinions like rounds of ammunition. You have no idea, I’d shouted at him. I know better than anyone how much people don’t want to take care of their bodies. No one cares, not until the end, and then it’s too damn late.
He’d argued that it was his body, his choices, his right as a free man to be reckless. That no one should be able to force him at gunpoint.
Well he made that choice, I thought, watching as the UHD officers pulled the intoxicated woman toward the flashing siren of their converted ambulance.
And I get to do the same.
You’d never guess my favorite memory, Shen. It’s not the fancy Valentine’s Day dinner or star-gazing by the harbor, parked in that salty alcove we would come to call our spot. No, my most treasured moment with you was the day after Parker’s Place when we were too hungover to even think about leaving the apartment. I spent the whole day with my cheek on the toilet seat, wishing for the end as I stared at your sprawled body in the hallway, slumped, belt open in an erotic invitation I was in no shape to act on. You laughed at how pathetic we were and I threw a toilet paper roll at your face and then we spent our greasy, nauseated afternoon watching funny cat videos on YouTube and trying not to laugh because it made things worse.
Maybe you don’t believe it, but for all the times I took you hiking, that’s the one day I’d never give back.
I decided to take a detour on my way home. Call me sentimental, but if this was my last night with real, tangible cravings, I wanted to enjoy them. So I ducked into the dank side-alley two blocks from our — my — apartment and listened to the echo of my clogs on the sidewalk. This was one of the few places that hadn’t yet been fitted with retinal scanners, which was no surprise, really. I mean, the only thing down this road was bars, so it wasn’t like there was any question as to who would come down here.
It was disconcerting, though, how light I felt knowing that no one was watching the flicker of my gaze or the color of my irises, reading for the tiny inconsistencies that could indicate a health problem.
I walked straight and tall, clutching my messenger bag and ignoring the weight of what tomorrow would bring.
Until I found the door to Parker’s Place.
A huge sign had been duct-taped to the door. Its vibrant colors weren’t quite able to paint over the bleakness of its meaning.
This establishment has been found in violation of the Universal Health Directive Net Good clause and is now closed. Please remember, alcohol has zero health benefits and is now categorized as a liability to the future of America’s population. There is no such thing as drinking responsibly!
I tried to tell myself that it made sense. I tried to think about all the horrible things that day had done to our bodies, our livers, our logical minds. It was better not to be tempted. It was better not to want.
The ChemBalance would help.
Numa, don’t do it. Don’t make that choice.
As if to jerk away the shroud on my thoughts, my BioMonitor buzzed as it sampled my blood, prickling the inside of my wrist like a hoard of relentless mosquitoes.
Depression: In the zoomed-in architecture of the brain, neurons wave to one another across microscopic gulfs, propelling friendly reminders through the fluid like paper airplanes. Think, move, feel, they say. Morse code written in molecular dashes and dots. But then, a few neurons stop waving (or stop waving back). They stand closed and petulant, unwilling to respond. Their fellows work harder to pull in that slack, but the sea of unopened letters is heavy and dark, a black hole of the mind, a body that can’t get out of bed. And as jilted cellular neighbors stop putting in the effort and the stormclouds of the mind grow oppressively thick, temptation strikes. Because there is an exit. An eternal, alluring escape…
There was another letter waiting for me, this time stuffed into the side of the door. A part of me — that wonderful, logical part — wanted to rip it up before I could even read it, throw it out the window and watch it scatter like ratty pigeons.
But I never could resist Shen.
I opened it and read the desperate plea etched in toothy, jagged lines.
Numa, please. Don’t go through with it. You still have a choice. The UHD was a noble idea, fine. I understand why you supported it at first. But it’s gone too far now. I’m not alone in this. I can’t say more but meet me at our spot tonight at 11 and I’ll help you disappear. I promise, I’ll help you make that better world you wanted. But don’t let them ruin the woman I love.
Anger curdled in my stomach like sour milk, painting my insides with rage. I swallowed my pointless scream, eyes scrubbing the hallway as if I could still find him, still see the traces he left behind when he snuck in here to throw this poisoned dart. Or maybe he’d coerced one of his spies to do it, some sympathetic mailman or rebellious cleaning lady. How many in the city had joined his cause, been swayed by his magnetism? Were they smoking cigarettes and laughing at the poor, misguided doctor who was so very tired of watching people lose the ones they love?
“Fuck you, Shen,” I muttered, voice thick with wrath. “Fuck you.”
But even the venom of my fury had a bittersweet aftertaste, because by tomorrow afternoon a tiny machine in my brain would be there to smooth down my hackles, iron out the pleats of my emotions. It would inject serotonin in the right place, or maybe siphon off some adrenaline.
It would fix me.
Already my BioMonitor was beginning to rattle with warnings again, its beeping almost exasperated, as if to say not again. I stared at it. Took a deep, calming breath. Tried to re-center myself around the orbit of the UHD.
I did find my center, at least.
You still have a choice.
No, I thought, silencing the alarms. I’m not sure I ever did.
Addiction: There’s a monster in your head that’s barely tame, barely contained. You feed it sex and candy to placate its nighttime howls. But one day, you offer it something else. A new, wild treat it’s never seen before, never even known to demand. Maybe you laugh as you give it this new toy. Maybe you cry. Your pet monster doesn’t care, because it’s already inflating on a helium of stronger stuff. And soon it’s dragging you by the leash, yanking you across the park and you don’t know where it’s going but it’s probably nowhere good…
I took the subway this time, too tired to trudge past the condemnations on the buildings around me. Our favorite cheap Chinese food place, the bakery where Shen used to buy those greasy cronuts, the convenience store that sold the only fried Mars Bars in the state: all shuttered and dead, reminding the head-down commuters what New York had come to value.
But there was no escape down here on the underground trains, festooned as they were with scanners.
I slumped into a seat, leaning my forehead against the handrail. Infectious agents be damned, right then I just wanted to think.
What am I doing?
Opening my eyes, I saw a child looking back at me. She had big blue irises and a fist clutching a celery stick smeared with peanut-butter.
“Honey, finish your snack,” said a woman who was clearly her mother.
But the child had no interest, her attention wandering from me to the next stranger, puzzling out clues to solve her narrow existence.
No matter how hard you try, it’s never going to make sense, I wanted to tell her. But I didn’t, because her mother was still trying to get her to eat.
I closed my eyes again, letting the thrum of the subway do what the ChemBalance would have done, had I given it the chance.
The night you left was the worst pain I’ve ever felt in my life. Worse than the expiration date we’d all known my father had, worse than my mother’s slide into anxiety, worse even than the sudden midnight phone call that my best friend had OD’d. I remember wondering if a person could die from crying as I knelt on the floor and stared at the place you’d just been standing, the place you’d left vacant because I wouldn’t come with you. And I didn’t understand, not then, how you could be so selfish. Were you really walking away from me — from everything — just because you didn’t want to give up cigarettes and donuts and beer?
Now I see that maybe I was the selfish one.
Because you weren’t an equation that needed to be solved, and I was at my best when you wrapped me in your jacket, smelling of smoke, laughing as you ordered pizza that we’d both regret the next day. And maybe there’s balance in that.
Of course he was there, leaning against the hood of his old-fashioned car like a model or a warning. And even as I glared at him from the shadow of the warehouse, I felt myself grow at once tighter and looser, like a knot that doesn’t ever want to come undone.
Distantly, a foghorn sounded, spreading like mist on the salty night air. And I watched as his familiar leather jacket drifted on the breeze. It was faded at the elbows and around the pockets. Well-loved, as they say.
A cigarette smoldered on his inhale.
After several long moments, he dropped his gaze with a sigh, moving to the driver’s side door. His shoulders slumped as he pulled it open and that was all it took to make me step into the circular light of the streetlamp.
He swung around with a grin to see me scowling and looming and marching toward him like a tide.
“You came,” he said, spreading his arms in invitation.
“You shouldn’t have asked me to.” My fists curled, ready to swing. “You shouldn’t have done that. Do you have any idea what I’ve just given up? What you took me away from?”
Finally, I stopped, my glare brimming with wrathful demands.
He shook his head, unable to contain that goddamn smile.
“I know. And I’m sorry. But I’m glad you came, Numa. I’m really, really glad you came.”
And there I was, unable to stop that slow slide into his expression or resist the tug of his gravity. The howling emptiness inside me began to close. My shoulders drooped, not quite weightless but getting there.
I met his gaze, hating how much it felt like home.
Shen’s eyes crinkled into a smile.
“Now we enjoy the journey.”
“But where will we go?” My own eyes overflowed, streaking the shipyard dust that stained my cheeks. One trembling hand curled compulsively around my bare and pale wrist. “What will we do?”
“We fight for your dream. And mine.”
All at once he was pulling me close, into his smell and his worn jacket and the body that will one day collapse under his stubborn indifference. But I didn’t care. Because those mortal arms were tight around me, holding me together, pulling me apart.
And for now, that was enough.