The Child

Night Shift

Chapter 12: The Child

The calls involving children were the calls that broke the rule. The rule was Marcus's rule, the rule of the bank and the river, the rule that said: the river flows past you, you hold the bank, you do not become the river. The rule worked for the shootings and the domestics and the overdoses and the car accidents and the medical emergencies and the hang-ups and the 3 AM loneliness calls. The rule worked because the rule was a practice and the practice had been refined over the years and the refinement had produced a version of the rule that was strong enough to hold the bank against the force of the river's current, strong enough to keep the dispatcher upright at the console while the calls flowed past, strong enough to maintain the separation between the voice and the person, between the professional and the human, between the headset and the heart.

But the calls involving children broke the rule. The calls involving children broke the separation. The calls involving children sent the river over the bank and into the person and the person was Delia and Delia was a mother and the mother could not hold the bank when the child on the other end of the headset was a child and every child on the other end of the headset was Jaylen.

This was not a decision. Delia did not decide to hear Jaylen in the calls involving children. The hearing was involuntary, was automatic, was the mother's response to the sound of a child in distress the way the flinch was the body's response to the sound of a gunshot — not chosen but triggered, not willed but compelled, the body's deep programming overriding the training's careful programming, the mother overriding the dispatcher, the heart overriding the bank.

The call came at 11:17 PM on a Thursday, the second week of October. The double tone. The key. The connection.

"Memphis 911, what is the location of your emergency?"

The screaming started immediately. Not the caller screaming — a child screaming. The sound entered Delia's headset with the force of a physical thing, the sound a thing that traveled the distance from the caller's house to Delia's ear and arrived not as information but as impact, the sound hitting Delia's eardrums and her nervous system simultaneously, the eardrums processing the frequency and the volume and the timbre while the nervous system processed the meaning, the meaning that was: a child is in distress, a child is screaming, a child is in the kind of trouble that produces the kind of screaming that the body produces when the body is in danger.

But the screaming was not the worst sound. The worst sound was the sound underneath the screaming, the sound that Delia's trained ear identified before her conscious mind classified it — the sound of a child choking. The specific sound. The gagging, the gasping, the wet strangled sound of an airway that was blocked, an airway that was not allowing air to pass, an airway that was doing the thing that a blocked airway does, which is to produce the sound of the body's attempt to breathe through an obstruction, the sound that was the body's alarm, the body's siren, the body's 911 call, the body calling for help in the only language the body had, which was the sound.

And underneath the choking, the crying — the particular crying of a child who is choking and frightened and unable to breathe fully, the crying that was intermittent because the crying required air and the air was not fully available, the crying coming in bursts between the gagging, the crying the evidence that the child was conscious and the consciousness was the first question the protocol would ask and the first question was already answered by the crying, the crying the information, the crying the data.

"My baby — she's choking — oh God, she's choking, she can't breathe —"

The caller was a woman. The caller was the mother. The caller's voice was the voice of a mother watching her child choke, a voice that Delia recognized not from the protocol's training but from the mother's training, the training that was not taught in a classroom but was installed in the body at the moment the child was born, the training that programmed the mother to respond to the child's distress with a distress of her own, the mirror distress, the empathic distress that the mother could not control because the controlling would require the severing of the connection between the mother and the child and the connection could not be severed, the connection was biological, was neurological, was the thing that evolution had built into the species to ensure that the mother would respond to the child's danger.

"Ma'am, I need your address. Where are you right now?"

"4218 — 4218 Dunn Avenue — please, she's choking —"

Delia typed. The address entered the CAD. The mapping system located it — Whitehaven, south Memphis, a residential street that Delia knew, knew the way she knew all of Whitehaven, knew it as her neighborhood, knew the streets and the blocks and the houses. The address was seven blocks from Gloria's house. The address was eleven blocks from Delia's apartment. The proximity was irrelevant to the protocol — the protocol did not care about proximity, the protocol cared about the emergency — but the proximity was not irrelevant to Delia, the proximity was the thing that made the address a place she could see in her mind, a house on a street she had driven, a block in a neighborhood she had lived in for thirty-three years, and the child in the house was a child in her neighborhood.

"Ma'am, how old is the child?"

"She's three — she's three years old — please —"

Three years old. Not seven. Not Jaylen's age. But the distance between three and seven was not a meaningful distance in the place where the calls involving children lived, the place where every child was Jaylen and the age did not matter because the age was not the thing, the child was the thing, and the child was choking and the mother was screaming and Delia was at Console 7 and the protocol was opening to the branch, the choking branch, the pediatric choking branch, the branch that Delia had followed before but that she had not followed recently and that she was now following with the particular intensity that the calls involving children produced, the intensity that was the mother overriding the dispatcher, the mother inside the dispatcher pressing against the walls of the professional, pressing against the bank, the river rising.

"Ma'am, listen to me. I'm going to help you. I need you to listen carefully. Is the child conscious? Is she awake?"

"Yes — she's awake, she's crying, she's — oh God —"

"She's conscious and she's crying. That's good. That means air is getting through. I need you to listen to me now. I'm going to tell you exactly what to do. Can you hear me?"

"Yes — yes —"

"What did the child choke on? Do you know what she swallowed?"

"A — a grape — she was eating grapes — I cut them, I always cut them, but one — she must have gotten a whole one, I don't know how —"

A grape. The thing that the pediatric literature identified as one of the most common choking hazards for young children, the grape's size and shape designed by nature to be exactly the size and shape of a small child's airway, the grape a perfect plug, a smooth round obstruction that the airway could not expel easily because the smoothness gave the muscles nothing to grip, the shape fitting the airway the way a cork fits a bottle, and the child's airway was smaller than an adult's and the grape was proportionally larger and the combination was the choking, the sound that Delia was hearing through the headset, the sound that was a child's body trying to breathe around a grape seven blocks from Gloria's house in Whitehaven at 11:17 PM on a Thursday.

Delia dispatched EMS, Code 3. She keyed the radio with the minimum words — address, pediatric choking, three-year-old, conscious — the dispatch going out while she maintained the phone connection, the two channels operating simultaneously, the radio sending the units and the phone holding the mother, the dispatcher working both channels with the practiced coordination that the job required, the left hand on the keyboard dispatching while the voice on the headset instructed, the two tasks performed in parallel because the time, the time was the thing, the time the enemy, every second of choking a second of reduced oxygen, every second of reduced oxygen a second of potential damage, and the seconds were passing and the units were responding but the units were minutes away and the minutes were too many and the protocol existed for this reason, the protocol existed to turn the minutes into action, to fill the gap between the call and the arrival with the instructions that could save the child's life.

"Ma'am — what is your name?"

"Keisha — my name is Keisha —"

"Keisha, listen to me. I need you to do exactly what I say. Pick up your daughter. I need you to place her face-down on your forearm. Support her head with your hand. Her head should be lower than her chest. Can you do that?"

"I — she's — she's struggling —"

"I know she's struggling. She's scared. But I need you to hold her firmly. Face-down on your forearm, head lower than her chest. Tell me when you have her."

A sound — the sound of a mother picking up a child, the sound of the struggle, the child's body resisting because the child's body was panicking and the panic produced resistance, the resistance the body's attempt to fight the thing that was happening to it, the body not understanding that the mother's hands were the help, the mother's hands the response, the mother's hands the first unit on scene.

"I have her — I have her on my arm —"

"Good. Now I need you to give five back blows. With the heel of your hand — the bottom part of your palm — I need you to hit her between the shoulder blades. Hit her firmly. Five times. Count with me. One —"

Delia heard the blow. She heard it through the headset — the sound of a mother's hand striking her child's back, the sound that was wrong in every context except this one, the sound that in any other circumstance would be the sound of harm but that in this circumstance was the sound of help, the sound of the protocol, the sound of the mother following the instructions that the voice was giving.

"Two —"

The blow.

"Three —"

The blow. And underneath the blows, the child's sounds — the crying, the gagging, the struggle, the sounds of a three-year-old whose body was fighting the obstruction and whose mother's hand was fighting the obstruction from the other side, the two fights the same fight, the mother's fight and the child's fight against the grape that was blocking the air.

"Four —"

"Five —"

"Okay. Turn her over. Face up on your forearm, still supporting her head. I need you to give five chest thrusts. Place two fingers on the center of her chest, just below the nipple line. Push down firmly, five times. Count with me."

"I can't — she's slippery, she's crying —"

"You can do this, Keisha. You are doing this. Two fingers on the center of her chest. Push down. One —"

The thrust. The sound of fingers pressing on a child's small chest, the sound quiet, almost inaudible through the headset, but Delia heard it because her ears were tuned to the call, her hearing sharpened by the adrenaline and the focus and the particular attention that the calls involving children produced, the attention that was more than professional, was maternal, was the attention of a woman who had a child of her own and who was listening to another woman's child struggle to breathe and who was counting, counting the way she counted during the CPR calls but differently, counting with the particular urgency that the pediatric calls carried, the urgency that was the urgency of a child's life, a child's brain, a child's oxygen, the seconds passing and the oxygen depleting and the grape in the airway.

"Two — three — four — five —"

"Okay. Check her mouth. Can you see anything in her mouth? Tilt her head and look."

A pause. The pause of a mother looking into her child's open mouth, looking for the grape, looking for the thing that was blocking the air.

"I don't see it — I can't see anything —"

"Okay. We're going to do it again. Turn her face-down on your forearm. Five back blows. One —"

Delia counted. She counted and Keisha struck and the child cried and the cycle continued — the back blows and the chest thrusts and the mouth check, the protocol cycling through the steps, the steps repeated because the protocol said repeat, the protocol said continue the cycle until the obstruction is expelled or the child becomes unconscious, the two outcomes the protocol's branches, the two possibilities that the cycle was resolving toward, one branch the good outcome and the other branch the worst outcome and the protocol addressing both, the protocol providing instructions for both, because the protocol was prepared for everything, the protocol had been designed by people who had studied every outcome and had built the tree to accommodate every outcome and had given the dispatcher the script for every outcome including the outcome that the dispatcher could not bear to reach, the outcome where the child stopped crying and stopped struggling and stopped breathing and the unconscious branch opened and the CPR branch activated and the dispatcher began counting compressions on a three-year-old's chest.

"Two — three —"

And then the sound.

The cough. The gag. The wet expulsion. The sound of an airway clearing, the sound of the obstruction being ejected by the force of the mother's hand on the child's back, the force transmitted through the back to the lungs to the airway to the grape, the grape that had been lodged and was now dislodged, the grape expelled by the fifth cycle of back blows, the fifth repetition of the protocol's instruction.

And then the cry. The full cry. The cry that was not the strangled cry of a child who could not breathe but the open cry of a child who could breathe, the cry that was air, was volume, was the sound of the lungs filling and the vocal cords vibrating and the child crying the way children cry when they are frightened and relieved and confused and the crying was the proof, the cry the evidence that the airway was clear and the air was flowing and the child was breathing.

"She's — she's breathing — she spit it out, she spit it out — oh God, she's breathing —"

Keisha was crying. The mother was crying with the particular crying of a mother whose child has just been returned from the edge of the thing, the edge that the mother had been looking over for the past two minutes, the edge that was the place where the choking led if the protocol did not work, and the protocol had worked and the child was breathing and the mother was crying because the crying was the release, the release of the terror, the release of the adrenaline, the release of the body's tension that had been held during the back blows and the chest thrusts and the counting.

"Keisha, listen to me. The child is breathing. That's wonderful. EMS is on the way — they'll check her over to make sure she's okay. I want you to hold her upright, keep her calm, and watch her breathing. If she starts choking again, call me back immediately. But she's breathing now. She's breathing."

"Thank you — oh God, thank you — she's breathing, she's okay —"

"She's okay. You did that, Keisha. You did that with your hands. You saved her."

Delia said it and the saying was true and the truth was the thing, the truth that the mother's hands had done the work, the mother's hands had followed the instructions and the instructions had come through the headset from the protocol through the voice through the phone to the mother's ears and the mother's ears had sent the instructions to the mother's hands and the mother's hands had struck the child's back and the striking had expelled the grape and the expelling had cleared the airway and the clearing had saved the child and the saving was the chain, the chain that connected Console 7 to the house on Dunn Avenue, the chain that was voice to ear to hand to back to airway, the chain that held.

"EMS is almost there, Keisha. Stay with your daughter. They'll check her out."

"Thank you. Thank you."

"You're welcome. You did everything right."

Delia disconnected. She logged the call. She typed the narrative. She typed the disposition: pediatric choking, resolved, airway cleared prior to EMS arrival, patient breathing.

She sat at Console 7. She placed her hands on the desk, palms down, the way a person places their hands on a table when they need to feel something solid, something that does not move, something that is not a phone and not a headset and not a protocol but is a surface, a simple surface, the surface of the desk that was Console 7 that was the dispatch floor that was the building on Poplar Avenue that was the solid thing, the thing that did not choke, the thing that did not gasp, the thing that did not cry.

Her hands were shaking.

Her hands shook after the calls involving children. Not during — during the calls her hands were steady, her voice was steady, the protocol was steady, everything was steady because the steadiness was the work and the work required the steadiness and the child's life depended on the steadiness and the steadiness held. During the calls involving children, Delia was the voice, the voice was the instrument, the instrument was steady. But after — after the call, after the disconnection, after the log and the narrative and the disposition — after, the instrument was put down and the person emerged from the instrument and the person's hands shook because the person was a mother and the mother had just listened to a child choke and the child was three and the child was seven blocks from Gloria's house and the child was every child and the child was Jaylen.

Jaylen was not three. Jaylen was seven. Jaylen was asleep at Gloria's house, in the bed with the Spider-Man sheets, under the nightlight shaped like a moon. Jaylen was not choking. Jaylen was breathing. Jaylen was safe. Delia knew this. Delia's mind knew this — knew the facts, knew the address was not Gloria's address, knew the child was not Jaylen, knew the name was not Jaylen but was a three-year-old girl whose name Delia had not asked because the protocol for choking did not include the child's name, the protocol focused on the obstruction, on the airway, on the steps, and the name was not a step.

But the body did not know the facts. The body did not distinguish. The body heard a child choking and the body responded with the mother's response, the response that was the shaking, the shaking the body's aftershock, the body's earthquake, the body's seismic response to the call that had just passed through it, the call that had entered the headset and passed through Delia's professional layers — the training, the protocol, the voice — and had reached the layer beneath all the professional layers, the layer that was the mother, the layer that could not be trained, could not be protocled, could not be managed by the bank-and-river metaphor because the mother was not the bank and the child was not the river, the mother and the child were the same thing, the same body, the same person, the connection between them not a metaphor but a fact, a biological fact, and the biological fact overrode the professional practice and the overriding was the shaking.

She looked at the photograph. Jaylen on the desk, in the frame, in the school photograph, smiling. She looked at the photograph the way she always looked at it after the calls involving children — looked at it for proof, for evidence, for confirmation that her child was there, was real, was smiling, was not the child on the phone, was not the child who was choking, was not the child whose mother's hands had struck the back while Delia counted. The photograph was the talisman, the anchor, the object that held the mother's fear in place, that said: this child, your child, is safe. This child is at Gloria's house. This child is asleep. This child is breathing.

Marcus saw the shaking. Marcus always saw the shaking because Marcus had been sitting beside Delia for four years and the four years had taught him to see the things that Delia tried not to show, the things that the voice and the posture and the professional surface tried to contain but that the hands betrayed, the hands the body's honest witnesses, the hands the part of the body that could not maintain the performance after the call ended, the hands that shook.

He did not speak. He did not offer the thermos. He did not nod the nod. He reached across the space between Console 6 and Console 7 and he placed his hand on the desk near Delia's hand — not touching, not holding, but near, the nearness the thing, the nearness the gesture, the nearness saying: I am here. I see the shaking. I have shaken. The shaking passes. The shaking is the body's honesty. The shaking is the mother's truth. The shaking is the cost of being both things — the dispatcher and the mother, the voice and the person, the instrument and the woman — the shaking is the cost of the both, and the cost is paid after the call, in the silence, in the space, in the hands on the desk that tremble because the hands know what the voice did not say and what the protocol did not address and what the bank did not hold: that the child on the phone was Jaylen and was not Jaylen and was every child and was no child and was the child, the child who was choking, the child who was breathing now, the child who was saved, the child who was seven blocks from Gloria's house in Whitehaven on a Thursday night in October.

The shaking lasted ninety seconds. Delia timed it — not consciously, not with a watch, but with the dispatcher's internal clock, the clock that measured the calls and the gaps and the silences and the shakings, the clock that said: ninety seconds, and then the hands stilled, and the stilling was the return, the return of the bank, the return of the professional, the return of the voice, the return of the woman who could take the next call.

The phone beeped.

Delia looked at the phone. She looked at the screens. She looked at the photograph of Jaylen. She pressed the key.

"Memphis 911, what is the location of your emergency?"

She took the next call. She took the next call because the next call was the work and the work was the shift and the shift did not pause for the shaking, the shift did not accommodate the mother's ninety seconds of trembling, the shift continued because the city continued and the city's emergencies continued and the emergencies did not wait for the dispatcher to recover from the last call before producing the next call. The emergencies came when they came and the dispatcher answered when they answered and the answering was the discipline and the discipline was the thing that held the work together and the work together was the shift and the shift was the night and the night was the job.

She took the next call. And the next. And the next.

The night continued. The calls continued. The shift continued.

And at Gloria's house, seven blocks from 4218 Dunn Avenue, Jaylen slept in the bed with the Spider-Man sheets, under the nightlight shaped like a moon, breathing the easy breathing of a seven-year-old who was safe and did not know what his mother had just done, did not know that his mother had just counted while another mother's hands saved another child's life, did not know that his mother's hands were shaking at the desk of Console 7, did not know any of this because the not-knowing was the gift, the gift that Delia and Gloria had given him, the gift of a childhood that did not know what the night held.

He slept. He breathed. He was safe.

And his mother took the next call.