For the next few days, I slip into a routine. In the mornings, I go for runs. I go as far as I can along the beach; I hike past the tortoise breeding center and Concha de Perla; I take paths that lead me into the heart of Isabela and to its cliffed edges. Sometimes I see locals, who nod at me but don’t speak.

I am not sure if they are keeping their distance because of the virus, or because I am a foreigner. I watch fishermen leave the pier in Puerto Villamil in little pangas, heading out to catch food for their families.

I wake before the sun and go to sleep before eight, because I can only spend half the day outside. After the two P.M. curfew, I stay indoors, reading on my Kindle—until I run out of downloaded books. Then I creep onto the postage-stamp yard of sand that abuts the beach, swing in the hammock, and watch Sally Lightfoot crabs scuttle away from the surf.

Abuela brings me a meal sometimes, and it is a nice alternative to the pasta that is my main food group.

I do not see her grandson or the girl.

I start talking to myself, because my voice has gone rusty with disuse.

Sometimes I recite poetry I memorized in high school as I walk in the thorny desert of the center of the island: Had we but world enough, and time; this Coyness, Lady, were no crime. Sometimes I hum when I wring out my clothes, washed in the sink, and hang them to dry in the hot sun. Sometimes I let the ocean harmonize as I sing into its roar.

Always, I miss Finn.

I still haven’t been able to talk to him, but I have written him postcards every night. I hope to get stamps and mail them, and maybe find a

cellphone store in town where they can work out a way for me to text internationally. I also need clothing, because rinsing out my limited supply every night isn’t ideal. The few stores that are still open do not seem to have regular hours, and I keep timing it wrong. While trekking into town, I have

seen intermittent signs of life at the pharmacy, a shawarma stand, and a church. I decide that, later today, I will try my luck again in Puerto Villamil.

Before dawn, I go for a run, until my lungs are burning. When I reach a spiky black monolith of lava, I sit down on the sand and watch the stars burn out of the sky, like sparks on a hearth. By the time I walk back home, the tide is coming in. It erases my footprints. When I look back over my shoulder, it’s as if I was never there.

I take another blank postcard from the G2 Tours box and sit down on the hammock outside my apartment to finish my latest missive to Finn; then something at the edge of the water catches my eye. In the hazy blue light,

rocks look like people and people look like monsters, and I find myself walking closer to get a better look. I am almost at the shoreline before I realize it’s the girl from Concha de Perla, carrying a trash bag. She

straightens, as if she can sense me coming up behind her. She is holding a plastic water bottle with Mandarin characters on the label. “It’s not bad enough that the Chinese fishing fleets are poaching,” she says in perfect English. “They have to throw their crap overboard, too.”

She turns to me and jerks her chin along the rest of the beach, where other bottles have washed ashore.

She continues to pick up trash as if it’s perfectly normal for her to be here at the crack of dawn, as if I haven’t seen her cutting herself or being yelled at by Gabriel.

“Does your brother know you’re here?” I ask.

Her wide black eyes blink. “My brother?” she says, and then she huffs a sharp laugh. “He is not my brother. And it doesn’t really matter if he knows or not. It’s an island. How far away could I even get?”

When I was in school and that girl was harming herself, I felt like our

paths kept crossing. Probably they had before, too, but I hadn’t been aware. One day, as we passed in the hallway, I stopped her. You shouldn’t do it, I said. You could really hurt yourself.

She had laughed at me. That’s the point.

I watch this girl pick up a few more plastic bottles and jam them into her bag. “You speak English so well.”

She glances at me. “I’m aware.”

“I didn’t mean—” I hesitate, trying to not say something inadvertently offensive. “It’s just nice to have someone to talk to.” I reach down and grab a bottle, holding it out for her bag. “I’m Diana,” I say.

“Beatriz.”

Up close, she seems older than I first thought. Maybe fourteen or fifteen, but petite, with sharp features and bottomless eyes. She is still wearing her sweatshirt, arms pulled low beyond her wrists. There is a school crest over her heart. She seems perfectly content to ignore me, and maybe I should respect that. But I am lonely, and just days ago, I watched her self-harming. Maybe I am not the only one who needs someone to talk to.

I also know, based on our previous interactions, that she is more likely to flee than to confide in me. So I choose my words carefully, like holding out a crust of bread to a bird and wondering if it will dart away, or hop one step closer. “Do you always pick up the trash here?” I ask casually.

“Someone has to,” she says.

I think about that, about all the visitors, like me, who descend on the Galápagos. Economically, I’m sure it’s a boon. But maybe having all the

boats and tours suspended for a few weeks isn’t a bad thing. Maybe it gives nature a moment to breathe.

“So,” I say, making conversation. “Is that your school?” I point to my chest, in the same spot where the logo is on her sweatshirt. “Tomás de Berlanga?”

She nods. “It’s on Santa Cruz, but it shut down because of the virus.” “So that’s where you live?”

She starts walking; I fall into place beside her. “During the school year I live with a family in Santa Cruz,” she says quietly. “Lived with.”

“But this is where you were born?” I guess. Beatriz turns to me. “I do not belong here.” Neither do I, I think.

I follow her further down the beach. “So you’re on vacation.” She snorts. “Yeah. Like you’re on vacation.”

Her barb hits home; as holidays go, this isn’t exactly what I hoped for. “How come you go to school off-island?”

“I’ve been there since I was nine. It’s like a magnet school. My mother enrolled me because it was the best chance of getting me out of Galápagos forever, and because it was the last thing my father wanted.”

It makes me think of my own mother and father. Separate circles that didn’t even overlap to form a Venn diagram where I could nestle into both their spaces.

“He’s your father,” I guess. “Gabriel?”

Beatriz looks at me. “Unfortunately.”

I try to do the math; he seems so young to be her parent. He can’t be much older than I am.

She starts walking away. “Why was he yelling at you?” I ask. She turns. “Why are you following me?”

“I’m not …” Except, I realize, I am. “I’m sorry. I just … I haven’t had a conversation with anyone in a few days. I don’t speak Spanish.”

“Americana,” she mutters.

“I wasn’t planning on coming here alone. My boyfriend had to back out at the last minute.”

This, she finds intriguing; I can see it in her eyes. “He had to work,” I explain. “He’s a doctor.”

“Why did you stay, then?” she asks. “When you found out the island was closing?”

Why did I? It’s been only a few days, but I can barely remember.

Because I thought it was the adventurous thing to do? “If I had anywhere else to go, I would,” Beatriz says. “Why?”

She laughs, but it’s bitter. “I hate Isabela. Plus, my father expects me to live in a half-finished shack on our farm.”

“He’s a farmer?” I say, my surprise slipping out. “He used to be a tour guide, but not anymore.”

Likely, I think, because he was so unpleasant to his clientele.

“My grandfather owned the business, but when he died, my father closed it down. He used to live in the apartment you’re in, but he moved to the highlands, to a place without water or electricity or internet—”

“Internet? There’s internet on this island?” I hold up the postcard I am still clutching. “I can’t send email, and I haven’t been able to call my boyfriend, either … so I was writing him. But I can’t buy stamps … and I don’t even know if there’s still mail service …”

Beatriz holds out her hand. “Give me your phone.” I hold it out, and she taps through the settings. “The hotel has Wi-Fi.” She nods toward a building in the distance. “I put in their password—but it shits out more often than it works, and if they’re closed, they probably turned off the modem. If you still can’t connect, you could try getting a SIM card in

town.”

I take back my phone, and Beatriz reaches for another bottle. A rogue

wave soaks her arm, and she pushes her sleeve up before she remembers the red weals left by the razor blade. Immediately, she claps her palm over them, and juts her chin up as if daring me to comment.

“Thank you,” I say carefully. “For talking to me.” She shrugs.

“If you wanted to, you know, talk … again …” My eyes flicker to her arm. “Well, I’m not going anywhere in the near future.”

Her face shutters. “I’m good,” she says, yanking down the wet fabric.

She looks at the postcard, still in my hand. “I could mail it for you.” “Really?”

She shrugs. “We have stamps. I don’t know about the post office, but fishermen are allowed off-island to deliver what they catch, so maybe

they’re taking mail to Santa Cruz.”

“That would be …” I smile at her. “That would be amazing.” “No big deal. Well. Gotta go check in with the warden.”

When I glance up, I realize we have walked all the way to town. “Your father?” I clarify.

“Tanto monta, monta tanto,” she says.

I wonder if the reason Gabriel is keeping such a tight rein on Beatriz is because he knows she’s cutting. I wonder if he isn’t angry, but desperate.

“Could you stay with your mom instead?” I blurt out.

Beatriz shakes her head. “She’s been gone since I was ten.” Heat rushes to my face. “I’m so sorry,” I murmur.

She laughs. “She’s not dead. She’s on a Nat Geo tour ship in Baja, fucking her boyfriend. Good riddance.” Without saying another word,

Beatriz slings the bag over her shoulder and walks down the middle of the main street, scattering startled iguanas in her wake.

The proprietor of Sonny’s Sunnies speaks English and sells more than

sunglasses and sarongs. She also sells T-shirts and neon-bright bikinis and SD cards for cameras and, yes, SIM cards for international calling— although there are none in stock at the moment. I can’t believe my continued streak of bad luck. She’s right there where Beatriz said I’d find her, on the main street of Puerto Villamil, just before noon. The door is

wide open and Sonny is sitting behind the cash register, fanning herself with a magazine. She is round everywhere—her face, her arms, her swollen

belly—and she peers at me over an embroidered mask. “Tienes que usar una mascarilla,” she says, and I just stare at her. The only word I understand in her sentence sounds like eye makeup, and I’m not wearing any.

“I … no habla español,” I stammer, and her eyes light up.

“Oh,” she says, “you’re the turista.” She points to her face. “You need a mask.”

I glance around the store. “I need more than that,” I tell her, making a small pile on the counter—Galápagos tees, two pairs of shorts, a sweatshirt, a bikini, a face mask made of cloth with little chili peppers printed on it. I add a guidebook with a map of Isabela. When I show her my phone, she

shows me a SIM card that will let me make local calls on a local network, which I buy even though I can’t imagine who I’ll be calling or texting locally. No, she tells me, she doesn’t sell stamps.

Finally, I pull out a credit card. “Do you know where there’s an ATM on the island?”

“Oh,” she says, putting my card in one of those old machines that create a carbon copy of it. “There’s no ATM.”

“Not even at the bank?”

“No. And you can’t use a credit card there to get cash.”

I look at the minuscule amount of money I have left, after paying Abuela

—thirty-three dollars. Minus ferry fare returning to Santa Cruz … as I do

the math, my heart starts pounding. What if my cash supply doesn’t last me for another week and a half?

My panic attack is interrupted by the jingle of the bell on the door. In

walks another woman in a mask, carrying a toddler. He squirms in her arms, calling out to the shop owner until he is set down on the floor and races toward her, clinging to her leg like a mollusk. She swings him onto her hip.

The woman who carried in the little boy unleashes a torrent of words I cannot understand and then she seems to notice me.

She looks familiar, but I can’t figure out why until she snaps toward the proprietor, and her long, black braid whips behind her. The woman from my hotel, whose name tag read Elena. Who told me they were closed.

“You are still here?” she says.

“I’m staying with … Abuela,” I reply. That means grandmother, I know.

I’m embarrassed to not know her real name.

“La plena!” Elena scoffs, throws up her hands, and slams out of the store.

“You’re staying in Gabriel Fernandez’s old place?” the shop owner asks, and when I nod, she laughs. “Elena’s just pissed because she wanted to be the one sleeping in his bed.”

I feel my cheeks heat. “I’m not … I don’t …” I shake my head. “I have a boyfriend at home.”

“Okay,” she says, shrugging.

To: DOToole@gmail.com From: FColson@nyp.org

I keep checking my phone to see if you’ve texted. I know it isn’t your fault, but I wish I knew for sure you are okay. Plus, I need some good news.

This virus is like a storm that just won’t ease up. You know on some rational level that it can’t stay like this forever. Except, it does. And gets worse.

The easy-to-diagnose Covid patient has fever, chest pain, a cough, a loss of smell and a metallic taste in their mouth, hypoxia, and fear.

The ones that aren’t as obvious arrive with abdominal pain and vomiting.

The ones you get Covid from have no symptoms and go to the ER because they cut their hands slicing a bagel.

My attending said we should assume everyone in the hospital has Covid. He’s pretty much right.

But weirdly, the ER isn’t very busy. No one’s just walking in anymore, they’re too scared. You never know if the guy with the broken leg sitting next to you in the ER is Covid-positive and asymptomatic. God forbid you cough, even if you have a common cold. You’ll be looked at like you’re a terrorist.

Since no one wants to risk coming to the hospital, most of the patients arrive by ambulance, coming only when they’re unable to breathe.

I’ve been assigned to one of the Covid ICUs. It’s loud AF. There are beeps and alarms that go off any time a vital sign changes. The ventilator makes a noise every time it breathes for a patient. But there are no visitors. It’s weird for there to be no crying wives or family members holding a patient’s hand.

Oh, and every day, treatment changes. Today we’re giving hydroxychloroquine.

Tomorrow: whoops, no, we’re not. Today we’re trying remdesivir, but antibiotics are out. One attending is pushing Lipitor, because it lowers inflammation. Another’s trying Lasix, used for heart failure patients, to help remove fluid from around Covid lungs. Some docs think ibuprofen is doing more harm than good, although no one knows why, so they’re giving Tylenol for fever instead. Everyone wants to know if convalescent plasma helps, but we don’t have enough of it to know.

When I’m not with a patient, I’m reading studies to see what other docs are doing in other places, and what clinical trials are available. It’s like we’re throwing shit at a wall to see if anything sticks.

Today, I had a patient who was bleeding through her lungs. Normally, we’d give a thousand milligrams of steroids to stop the hemorrhage, but my attending was waffling, because based on previous flu studies, we’re worried that steroids might make Covid

worse. I kept watching him wrestle with a course of action, and all I could think was: does it matter, if she’s dead either way?

But I didn’t say anything. I left the room and did my rounds, listening to lungs that couldn’t push air and hearts that barely were beating, checking vitals and fluid status, hoping that the patients I was checking on could ride out the virus before we run out of beds. There is a thousand-bed Navy ship being sent to NYC but it won’t get here till April; and based on estimates, the hospitals in the city will max out of beds in 45 days.

It’s only been a week.

I decided I’m not listening to the news anymore, because I’m basically living it. God, I wish you were here.

In 2014, one of the plaster rosettes fell from the ceiling of the Rose Main Reading Room of the New York Public Library and shattered on the floor. When the city decided to inspect it, they also inspected the ceiling in the adjacent Blass Catalog Room. The ornate plasterwork of that ceiling was touched up and tested for weight and strength. The 1911 James Wall Finn trompe l’oeil mural of the sky on canvas, however, couldn’t be restored

because it was too fragile. Instead, my father spent nearly a year re-creating the image on canvas that would be set in place on the ceiling, and could be easily removed for touch-ups in the future.

When the canvases were being installed in 2016, he was there directing the operation. Because he was a perfectionist, he insisted on climbing up a ladder to illustrate how the edge of the canvas had to align, flush, with the gilded satyrs and cherubs of the carving that framed it.

That same day, I was in East Hampton, at the second home of a woman who was auctioning off a Matisse with Sotheby’s. Our protocol required

someone from the auction house to be present when a piece was transported, and since I had just been promoted to a junior specialist in Imp Mod, I was given the assignment. It was mindless work. I would take a company car to the site, meet the shipping company there, and before it was packed up I’d use a printed copy of the painting to mark down any

scratches or peels or imperfections. I’d oversee the careful packing of the piece, watch it get loaded into a truck, and then I would get back into my company car and return to the office.

The job, however, was not going according to plan. Although our client had said her housekeeper would be expecting us, her husband was also home. He’d had no idea that his wife was selling the Matisse, and he didn’t want to. He kept insisting that I show him the contract, and when I did, he told me he was going to call his lawyer, and I suggested he should maybe call his wife instead.

The whole time, my phone was buzzing in my pocket.

When I finally answered, the number was not one I recognized.

Is this Diana O’Toole?

I’m Margaret Wu, I’m a doctor at Mount Sinai … I’m afraid your father’s been in an accident.

I walked out of the house in the Hamptons, dazed, completely oblivious to the man still on the phone with his lawyer and the movers awaiting my approval to wrap up the painting. I got into the company car and directed

the driver to take me to Mount Sinai. I called Finn, whom I’d been dating for several months, and he said he’d meet me there.

My father had fallen off a ladder and struck his head. He was hemorrhaging in his brain, and had been taken directly into surgery. I wanted to be there holding his hand; I wanted to tell him it was going to be all right. I wanted my face to be the first thing he saw in the recovery room.

The traffic on Long Island was, as usual, a disaster. As I cried in the backseat of the company car, I bargained with a higher power. I will give You anything, I swore, if You get me to the hospital before my father wakes up.

Finn stood up as soon as I walked through the sliding glass doors, and I knew. I could tell from the look on his face and the speed with which he wrapped his arms around me. There was nothing you could have done, he whispered.

That was how I learned that the world changes between heartbeats; that life is never an absolute, but always a wager.

I was allowed to see my father’s body. Some kind soul had wrapped

gauze around his head. He looked like he was asleep, but when I touched his hand, it was cold, like a marble bench in winter that you will not linger on, no matter how weary you might be. I thought of how his heart must

have caught when he lost his footing. I wondered if the last thing he saw was his own sky.

Finn held my hand tight as I signed paperwork, blinked at questions about funeral homes, answered in a daze. Finally, a nurse gave me a plastic bag with the hospital logo on it. Inside was my father’s wallet, his reading glasses, his wedding ring. Identity, insight, heart: the only things we leave behind.

In the taxi on the way home, Finn kept one arm anchored around me

while I clutched the bag to my chest. I reached into my purse for my phone

and scrolled to the last text my father had sent me, two days ago. Are you busy?

I had not answered. Because I was busy. Because I was going to his place for dinner that weekend. Because he often decided he wanted to chat in the middle of business hours, when I couldn’t. Because there were any number of items on my to-do list that took precedence.

Because I never thought that I’d run out of time to respond. The story of our life was a run-on sentence, not a parenthetical.

Are you busy?

No, I typed in, and when I pushed send, I started sobbing.

Finn reached into his jacket, looking for a tissue, but he didn’t have one. I scrabbled inside my own coat pocket and came up with the rectangular printout of the painting I had gone to pack up just that morning, a thousand years ago. I looked at the red circles and arrows meant to signify the marks and chips on the frame, the nick on the canvas, as if they meant anything.

As if we don’t all have scars that can’t be seen.

Dear Finn,

Well, it’s still beautiful here, and I’m still the only tourist on this island. In the mornings, I go out for runs or hikes, but in the afternoon the whole place is locked down. Which feels redundant, when you’re

this isolated.

Sometimes I find myself eye to eye with a sea lion or sharing a

bench with an iguana and I’m just blown away by the fact that I’m that close, and there’s no wall or fence between us, and that I don’t feel

threatened. The fauna was here first, and in a way they still lord it over the humans who now share the space. I wonder what it would be like if I wasn’t the only one marveling over them. I mean, the locals are all used to it. I’m a one-woman audience.

The great-granddaughter of the woman who is renting me a room speaks English. She’s a teenager. Talking to her makes me feel less

lonely. I hope I do the same for her.

Every now and then I get a hiccup of cell service and one of your emails arrives in my inbox. It feels like Christmas.

Are you getting any of these postcards?

Love, Diana

The next morning, when Beatriz rounds the corner with her trash bag—a one-girl recycling crew—I am sitting at the shoreline, making a drip castle.

From the corner of my eye, I see her, but I don’t turn. I can feel her watching me as I scoop up a handful of wet sand, and let it sift through my fingers, creating a craggy turret.

“What are you doing?” she asks.

“What does it look like I’m doing?” I say.

“It doesn’t even look like a castle,” she scoffs.

I lean back. “You’re right.” I hold out my hand for her plastic bag. “Do you mind?”

She hands it to me. Mixed in with the same plastic water bottles from the Chinese fishing fleets are twist ties, burlap curled with seaweed, scraps of foil. There’s a broken flip-flop, green plastic soda bottles, red Solo cups.

There’s electric-blue netting from a bag of oranges, and a tongue of rubber tire. I pull all of these out and use them to fashion flags on my castle turret, a moat, a drawbridge.

“That’s trash,” Beatriz says, but she sinks down cross-legged beside me.

I shrug. “One person’s trash is another person’s art. There’s a Korean artist—Choi Jeong Hwa—who uses recycled waste for his installations. He made a massive fish puppet out of plastic bags … and a whole building out of discarded doors. And there’s a German guy, HA Schult, who makes life- size people entirely out of garbage.”

“I’ve never heard of either of them,” Beatriz says.

I take the thong off the flip-flop and create an archway. “How about Joan Miró?” I offer. “He spent the end of his life on Mallorca, and he’d walk the beach every morning like you, but he’d turn the trash he collected into

sculptures.”

“How do you even know this?” she asks. “It’s my job,” I tell her. “Art.”

“You mean, like, you paint?”

“Not anymore,” I admit. “I work for an auction house. I help people sell their art collections.”

Her face lights up. “You’re the person who says I have one dollar, one dollar, do I hear two …”

I grin; she does a credible job of imitating an auctioneer. “I’m more behind the scenes. The auctioneers are kind of the rock stars of the industry.” I watch Beatriz take a handful of tiny shells and line the moat

with them. “There was this one British auctioneer we all had a crush on— Niles Barclay. During auctions, I was usually assigned to be on the phone with a collector who wasn’t physically present and make bids on his or her behalf. But once, I was pulled to be Niles Barclay’s assistant. I had to stand on the podium with him and mark down the sales price of the item on the information sheet when the bidding closed, and hand him the next information sheet to read out loud. Once, our hands touched when I was passing him the paper.” I laugh. “He said, Thank you, Donna, in his amazing British accent, and even though he got my name wrong I thought: Oh my God, close enough.”

“You said you had a boyfriend,” Beatriz says.

“I did. I do,” I correct. “We gave each other one free pass. Mine was

Niles Barclay; his was Jessica Alba. Neither one of us has cashed in on our pass.” I look at her. “How about you?”

“How about me what?” “Do you have a boyfriend?”

She flushes and shakes her head, patting the sand. “I mailed your postcard,” she tells me.

“Thanks.”

“I could stop by, if you want,” Beatriz says. “Like, I could come to your place every now and then and pick them up, if you’re sending any more.”

I look at her, wondering if this is an offer of help, or a need for it. “That would be great,” I say carefully.

For a few moments, we work in companionable silence, forming crenellated walkways and buttresses and outbuildings. As Beatriz stretches, reaching into the trash bag, her sleeve inches higher. It’s been a few days

now since I saw her cutting herself. The thin red lines are fading, like high- water marks from a flood that’s receded.

“Why do you do it?” I ask softly.

I expect her to get up and run away, again. Instead, she digs a groove into the sand with her thumb. “Because it’s the kind of hurt that makes sense,”

she says. She angles her body away from mine and busies herself by connecting some twist ties.

“Beatriz,” I say, “if you want—”

“If I were making things from trash,” she interrupts, shutting down the previous line of conversation, “I’d make something useful.”

I look at her. We’re not done talking about the cutting, I say with my eyes. But I keep my voice casual. “Like what?”

“A raft,” she says. She sets a leaf on the water of the moat, which keeps seeping into the sand until one of us refills it.

“Where would you sail?” “Anywhere,” she says. “Back to school?”

She shrugs.

“Most kids would be thrilled with an unscheduled break.”

“I’m not like other kids,” Beatriz replies. She adds a bit of yellow plastic hair to her twist tie creation, which is a stick figure with arms and legs. “Being here … feels like moving backward.”

I know that feeling. I hate that feeling. But then again, these are

circumstances beyond normal control. “Maybe … try to embrace that?” She glances at me. “How long are you going to stay?”

“Until I’m allowed to leave.” “Exactly,” Beatriz answers.

When she says it, I realize how important it is to have an out. To know that this is an interlude, and that I’m going home to Finn, to my job, to that plan I set in place when I was her age. There is a profound difference between knowing your situation is temporary and not knowing what’s coming next.

It’s all about control, or at least the illusion of it.

The kind of pain that makes sense.

Beatriz sets her little figure atop the castle: a person in a building without doors or windows or ladders, a structure surrounded by a deep moat.

“Princess in a tower?” I guess. “Waiting to be rescued?”

She shakes her head. “Fairy tales are bullshit,” Beatriz says. “She’s literally made out of trash and she’s stuck there alone.”

With my fingernail, I carve out a back door to the castle. Then I wind

some seaweed around a plastic spoon, dress it in a candy wrapper, and set my figure down beside hers—a visitor, an accomplice, a friend. I look up at Beatriz. “Not anymore,” I say.

To: DOToole@gmail.com From: FColson@nyp.org

The hardest hit are Hispanics and Blacks. They’re the essential workers, the ones who are in the grocery stores and mailrooms and fuck, even cleaning the hospital rooms

we’re using. They take public transportation and they’re exposed to the virus more frequently and there are often multiple generations living under one roof, so even if a teenage Uber Eats driver contracts Covid and doesn’t show symptoms, he might be the one who kills his grandfather. But what’s even worse is—we’re not seeing these patients until it’s too late. They don’t come to the hospital, because they’re afraid ICE is hanging out here, waiting to deport them, and by the time they can’t breathe anymore and they call an ambulance, there’s nothing we can do.

Today I watched a Hispanic lady who’s part of the cleaning crew at the hospital wipe down a room. I wondered if anyone’s bothered to tell her to strip in her entryway when she gets home and shower before she lets her kids hug her.

We finally got a new shipment of PPE. But it turns out that instead of N95 masks, which is what we really need, they sent gloves. Thousands and thousands of gloves. The guy who accepted the delivery is the chief of surgery and every resident I know is terrified of him because he is so intimidating, but today, I saw him break down and cry like a baby.

We have a new trick: proning. It’s tummy time, for adults. Its mortality benefit has been around in studies since 2013, but it’s never been used as much as it is now. We do it for hours, if the patient can take it. The way your lungs work, when you’re on your belly they have more room to expand and the blood flow and airflow are equilibrated enough to hold off intubation for a while. We’ve learned that patients can seem to tolerate a huge decrease in air exchange so now instead of only looking at the numbers for gas exchange, we look to see which patients are worn out from breathing, and they’re the ones who get intubated. That’s the good thing. The bad thing is that if someone decompensates, and needs intubation after a trial of no intubation, they will certainly die, because when lungs are already damaged by quick breathing, by the time they’re ventilated, it’s too late. We are basically playing Russian roulette with people’s lives.

One of the three patients of mine that died today was a nun. She wanted last rites and we couldn’t find a priest who was willing to come into the room and administer them.

Sorry if there are typos—I keep my phone in a Ziploc bag when I’m at the hospital.

I’m wiping down the bills that come in the mail. A nurse told me she washed her

broccoli with soap and hot water. I can’t remember the last time I ate a cooked meal.

I wish I knew for sure that this was getting through to you. And I wish you’d answer back.

Dear Finn,

I wish I could tell you how badly I’m trying to reach you, although the fact that I can’t is sort of the point. Remember how we thought it would be so romantic to be shut away from the outside world? It doesn’t feel that way when I’m alone on the outside, banging to be let back in.

It makes for some pretty weird self-reflection. It’s like I am in some parallel universe where I am aware of other things going on, but I can’t respond or comment or even be affected by them. LOL, is the world even turning, if I’m not really a part of it?

The girl I told you about, she says that being here feels like moving backward. I know I should be grateful to be safe and healthy and in a gorgeous bucket list destination. I know this was the perfect time for

this to happen, with my job in limbo and you stuck at the hospital. I also know that when you’re in the thick of living your life, you don’t often get to push pause and reflect on it. It’s just really hard to sit in the moment, and not worry if pause is going to turn into stop.

Jesus, I am bad at having downtime. I need to find a way to keep myself occupied.

Or I need to find a plane. A plane would be good, too.

Love, Diana

After I’ve been on the island for a little over a week, Abuela invites me to lunch.

I have not been inside her home before now. It is bright and cozy, with a

tangle of plants on the windowsills and yellow walls and a crocheted afghan on the couch. There is a ceramic cross hanging over the television set, and

the entire space smells delicious. On the stove is a pan; she walks to it and moves the contents around with a spatula before lifting the utensil and pointing at the kitchen table so I will sit down.

“Tigrillo,” she says a moment later, when she sets a plate down in front of me. Plantains, cheese, green pepper, onions, and eggs. She motions for me to take a bite, and I do—it’s delicious—and then with satisfaction,

Abuela turns back to the stove and loads a second plate. I think she is going to join me, but instead she calls out, “Beatriz!”

Beatriz is here? I haven’t seen her for four days, not since we built the sandcastle together.

I wonder if she ran away from her dad’s farm again.

From behind a closed door on the other side of the living room comes a flurry of angry response I cannot understand. Abuela mutters something, setting the plate on the table and resting her hands on her hips in frustration.

“Let me try,” I say.

I pick up the plate and walk to the door; knock. The response is another muffled stream of Spanish. “Beatriz?” I say, leaning closer. “It’s Diana.”

When she doesn’t answer, I turn the knob. She is lying on a bed that’s covered by a plain white cotton blanket. She is staring up at the ceiling fan, while tears stream from the corners of her eyes into her hair. It is almost as

if she doesn’t realize she is crying. Immediately I set the plate on a dresser and sit next to her. “Talk to me,” I beg. “Let me help you.”

She turns onto her side, presenting her back to me. “Just leave me alone,” she says, crying harder.

After a moment, I stand up and close the door behind me again. Abuela looks at me, her heart in her eyes. “I think she needs help,” I say softly, but Abuela just cocks her head, and my worry is lost in translation.

Suddenly the front door opens and Beatriz’s father stalks in. “Ella no

puede seguir haciendo esto,” he says. Abuela steps forward, putting a hand on his arm.

He makes a beeline for the bedroom door. Without thinking twice, I step directly in his path. “Leave her be,” I say.

Gabriel startles, and I realize he has been too furious and single-minded to clock my presence. “Porqué está ella aquí?” he asks Abuela, and then looks at me. “What are you doing here?”

“Can we talk?” I say. “Privately?”

He stares at me. “I’m busy,” he grunts, trying to dodge around me for the doorknob.

I realize I’m not going to be able to divert him, so I pitch my voice lower, assuming that Abuela cannot understand English any better than I can understand Spanish. “Do you know that your daughter cuts herself?” I murmur.

His eyes, already nearly black, manage to darken. “This is none of your business,” he says.

“I just want to help. She’s so … sad. Lost. She misses her school. Her friends. She feels like there’s nothing for her here.”

“I’m here,” Gabriel says.

I don’t respond, because what if that’s the problem?

A muscle tics in his jaw; he is fighting for patience. “What makes you think I would listen to a Colorada?”

I have no idea what that is, but it can’t be a compliment.

Because I was a kid once, I think. Because I had a mother who abandoned me, too.

Instead, I say, “I guess you’re an expert on teenage girls?”

My words do exactly what my physical interception didn’t: all the anger leaches from him. The light goes out of his eyes, his fists go slack at his

sides. “I am an expert on nothing,” he admits, and while I am still turning this confession over in my mind, he reaches past me for the doorknob.

I do not know what I expect Gabriel to do, but it’s not what he actually does: He goes into the room and sits gingerly on the bed. He brushes Beatriz’s hair back from her face until she rolls over and looks up at him with her swollen, red eyes.

I feel a shadow at my back, and Abuela walks into the bedroom. She

stands behind Gabriel, her hand on his shoulder, completing the circuit of family.

I feel like I am in the middle of a play, but nobody has given me a script.

Silently, I back away and slip out the front door.

Isolation, I think, is the worst thing in the world.

To: DOToole@gmail.com From: FColson@nyp.org

Before the mayor closed all nonessential businesses in the city today, I went to Starbucks on my way to work. I was in my scrubs, and I was masked, of course. I don’t go anywhere without a mask. The barista was joking around. She said, I sure hope you don’t work with Covid patients. I told her I did. She literally fell back three feet. Just …

fell back. If that’s how I’m being treated—and I’m not even sick—imagine how it feels to be one of those patients, alone in a room with nothing but stigma to keep you company. You aren’t a person anymore. You’re a statistic.

The Covid ICU, which used to be the surgical ICU, is just a long line of patients on ventilators. When you walk into the ward it’s like a sci-fi movie; like these very still bodies are just pods incubating something terrifying. Which is kind of the truth.

We’re trying to be more careful about intubating because based on our experience, once a person’s on a vent he’s less likely to get off it. By now, I could identify the lungs of a Covid patient in my sleep (and some days, it kind of feels like that’s what I’m doing). It’s this vicious cycle—if you can’t breathe deeply, you breathe fast. You can only breathe 30 times a minute for so long before you exhaust yourself. If you can’t breathe, you can’t stay conscious. If you can’t stay conscious, you can’t protect your airway, so you might aspirate. And that’s how you wind up being intubated.

We give etomidate and succinylcholine before we put the GlideScope down the throat and bag the patient, because there’s a slight delay before getting hooked up to a ventilator. Ideally, you want to keep the patient comfortable but able to open his eyes and follow basic commands. The problem is that Covid patients have such low oxygen levels they are delirious—and we have to sedate them deeper in order to control their breathing and make sure they’re not fighting the ventilator. So that means doses of

propofol or Precedex or midazolam, some kind of ketamine for sedation—plus analgesics like Dilaudid or fentanyl for pain—and on top of that, if they’re restless, we

will paralyze them with rocuronium or cisatracurium so they aren’t trying to overbreathe the vent, and inadvertently damaging themselves. They’re on a whole cocktail of drugs

… and not a single one actually treats Covid.

Man. What I’d give to know what your day was like. What you’re thinking. If you miss me as much as I miss you.

I hope you don’t. I hope wherever you are right now, it’s better than this.

The next morning, I open the sliding glass door for my morning run down the beach and nearly collide with Gabriel. He is carrying a big cardboard box that is overflowing with vegetables and fruits, some of which I don’t even recognize. I am certain I am dreaming this, until he reaches out one hand, steadying me so we do not crash. “These are for you,” he says.

I’m not sure what to say, but I take the box from him.

He runs a hand through his hair, making it stand on end. “I am trying to say I’m sorry.”

“How’s it going for you so far?”

Two bright burns of color stain his cheeks. “I should not have … treated you as I did yesterday.”

“I only wanted to help Beatriz,” I say.

“I don’t know what to do for her,” he says quietly. “I didn’t know she was hurting herself … until you said so. I don’t know what’s worse—that she’s doing it, or that I didn’t even notice.”

“She hides it,” I tell him. “She doesn’t want anyone to know.” “But … you do.”

“I’m not a psychologist,” I say. “Is there someone here she could talk to?”

He shakes his head. “On the mainland, maybe. We don’t even have a hospital on island.”

“Then you could talk to her.”

He swallows, turning away. “What if talking about it makes her do more than just … cut?”

“I don’t think that’s how it works,” I say slowly. “I knew a girl who did this, back when I was younger. I wanted to help. A school counselor told me that if I reached out to her, it wouldn’t make her do it more, or do something more … permanent … but it might make her take steps to stop.”

“Beatriz won’t talk to me,” Gabriel says. “Everything I say makes her angry.”

“I don’t think she’s angry at you. I think she’s angry at …” I wave my hand. “This. Circumstances.”

He tilts his head. “She told me about the sandcastle. About people who make art … out of garbage.” Gabriel clears his throat. “She hasn’t given me more than two or three words at a time since she got back to the island a

week ago, but last night, she wouldn’t stop defending you.” He catches my gaze. “I’ve missed hearing my daughter’s voice.”

As an apology goes, that one hits the target. He is staring at me fiercely, as if there is more to say, but he does not know how. I break away, glancing down at the box in my arms. “This is too much,” I tell him.

“They’re from my farm,” he says, and then adds, with a hint of a grin, “since I couldn’t get you an ATM.”

That surprises a laugh out of me. “Does everyone know everyone’s business here?”

“Pretty much.” He shrugs. “You won’t want to leave those in the heat,” he says, then reaches behind me and pulls open the slider, so I can carry the box inside. I set it on the kitchen table gingerly, wondering if I should broach the topic of Beatriz again. Last night, I had thought maybe the girl

was running away from her overbearing father; now I am not so sure. Either Gabriel is the world’s greatest actor, or he is just as lost as his daughter is.

He looks at the box of blank postcards on the kitchen table. “What are you doing with those?”

“Basically, they’re my paper supply. I’ve been writing to my boyfriend.” Gabriel nods. “Well. At least they’re still good for something.”

“Oh!” I say. “Wait.” I whirl around, dart into the bedroom, and return with the neatly folded pile of very soft T-shirts I’d co-opted. “I wouldn’t have borrowed them if I knew they were yours.”

“They’re not.” He makes no move to take them from me. “Burn them, if you want.” He looks at my face, then sighs. “My wife used to sleep in them. I wasn’t upset because you borrowed them. It just … was like having a ghost walk over your grave.”

He says the word wife like it is a blade.

Suddenly he bends down, manipulating the wobbly leg of the table. “I should have fixed this before you moved in.”

“You didn’t know I was moving in,” I reply. “And you weren’t particularly thrilled by the idea, as I recall.”

“It is possible I judged—how do you say it?—the book by its jacket.”

I smile faintly. “By its cover.” I think about him sneering at me for being a tourist, for being an American. I start to feel indignation percolating

inside me, but then I remember that every time our paths have crossed, I’ve made poor assumptions about him, too.

He rips off a piece of the cardboard box, folds it, and uses it to balance the table. “I’ll come back this afternoon and fix it properly,” he says.

“Maybe Beatriz could join you,” I offer. “I mean, if she wants to.” He nods. “I will ask.”

Something blossoms between us, delicate and discomfiting—a silent second start, a willingness to give the benefit of the doubt, instead of expecting the worst.

Gabriel inclines his head. “I leave you to your morning, then,” he says, and he turns.

“Wait,” I call out, as his hand grasps the sliding door. “If you’re a tour guide, why do you hate tourists so much?”

Slowly, he turns. “I’m not a tour guide anymore,” he says.

“Well, since the island is closed,” I reply, “technically … I’m not a tourist.”

He smiles, and it is transformative. It’s like the first time you see a falling star. Every night after that, you find yourself searching again, and if you don’t see one, you feel crestfallen. “Maybe, then, one day, I can show you my island,” Gabriel offers.

I lean against the table. It is, for the first time in a week, sturdy. “I’d like that,” I say.