Jay Baruch's short story collection "Fourteen Stories: Doctors, Patients, and Other Strangers" (Kent State University
Press, 2007) was Honorable Mention in ForeWord Magazine's 2007 Book of the Year Awards in the short stories
category. His fiction has appeared in Other Voices, Bryant Literary Review, Hamilton Stone Review, Another Toronto
Quarterly, Inkwell, Segue, Ars Medica, Salt River Review, Tattoo Highway and others. He lives in Rhode Island, where he
practices emergency medicine and teaches medical ethics at Brown Medical School. http://www.jaybaruch.com
Patient 0478 sifts through sacks of lethal pills, brushes his fingers along knife handles, swings at the noose hanging from
a steel-enforced beam. He nods pleasingly at the many stations in the Suicide Stress Test. Noah sits up, rubs his
bloodshot eyes. The patient might actually kill himself. This rarely happens in Noah's work as a Sitter at the East Side
Empowerment Center. Thwarting such attempts is the very reason he sits for eight-hour shifts behind a bolted-down
metal desk in the locked, soundproof room.
Straining to quietly push back his chair, Noah spills the display of Empowerment Center flyers on his desk. The flyers
describe in flowery cursive the purpose of the Suicide Stress Test, euphemistically called SST. What better way to test the
seriousness of patients' claims to self-harm than to give them the opportunity and the support to end their life? The
cover boasts a glossy photograph of former SST patients - a rainbow of race and ethnicity. Smiles explode off their faces
as they hold slices of pizza weighed down with toppings. The caption: You can have it all.
On a good day, a person who is real, a true threat to take his or her life, stresses Noah's nerves to the snapping point.
This morning it's worse. A sleepless night leaves his body heavy, his head clotted with fatigue and confusion. Lauren left
him the night before while he was out with his friend Perk. Gone were her clothes from his bureau and closet, her
espresso maker, his radio-alarm clock. Her long pieces for the local newspaper drew notice for their insight and clarity.
Noah is baffled she didn't leave him a simple note.
Lost to Noah stacking flyers, Patient 0478 knocks on the bullet-proof glass of the converted phone booth. Once inside,
he touches the revolver welded to a movable, metal arm. Noah resists the urge for alarm. He didn't have time to oil the
arm's stiff joints this morning. To press the gun barrel to the temple, or inside the mouth, requires great effort.
The paperwork sent with Patient 0478 states he's a recently fired mortgage broker. He wears the residue of prosperity:
an uncombed mane of salt-and-pepper hair; a wrinkled monogrammed dress shirt that smells of tar and French fries; a
flushed face that Noah finds kind and trustworthy. If Patient 0478 doesn't have much to live for, Noah suspects he has
much to lose. His excellent health insurance only confirms Noah's security. Studies show people rarely attempt suicide
with coverage this good.
Patient 0478 chuckles at the adjustable headrest. He raises his chin. A thoughtful, bemused expression lights his face. He
recognizes that this desire to end his life was rash, even silly, Noah thinks, when Patient 0478 pulls the trigger and takes
the blast in the chest.
While Environmental Services completes a terminal clean on the room and Patient 0478 is carted off to the morgue, Noah
sits shell-shocked in his supervisor's office. "This death might qualify as a negligent demise," says Mrs. Curling. Her flat,
unemotional gaze peers over stylish Tortoise shell eyeglasses.
"Tell me Noah, according to the SST manual, when should a Sitter initiate active intervention?"
Noah holds his answer. He's shaking too much. He's drinking vending machine coffee, which makes him shake more.
"Guideline 2.1 states intervention is indicated only when a patient demonstrates commitment to a course of action that
will result in imminent harm."
"Yes. Imminent harm," says Mrs. Curling. Her face twists in pain when he finishes quoting the manual verbatim. She's
chunky, attractive, with large gray eyes. He would consider her beautiful if not so fearful of her judgment. She reads
paperwork Noah filled out twice, the first draft erroneously completed in blue ink, not the official black.
"You're my best Sitter," she says, sighing with disappointment. "But if you're found at fault, it will be your second
negligent demise, and grounds for dismissal."
Noah sits across from her desk, muscles cramping, pretending that he isn't fully vested in his 401K in two short months.
He's exhausted. He can almost convince himself that what happened was a bad dream. The moment plays in his head
over and over. The gun flashes. The body flails backward. Noah flinches every time. Shocked. Sickened.
"Do you think you could have prevented this, Noah?"
"I don't... " His voice trembles under the weight of the words. "I don't know."
“I can’t believe it happened. I can’t believe I let it happen,” Noah tells Perk later that evening. They’re sitting in an
uncomfortably bright bagel shop. “Maybe it’s an omen, maybe it’s time to call it quits.”
“Chill out. Your girlfriend leaves you. A patient kills himself. OK, not a good day. But you get paid to sit. When my trust
fund runs dry, I want your job.”
“The job has changed,” mumbles Noah, watching Perk eat egg salad on poppy. A mouse scurries out the wall, hugs egg
and celery droppings. Appetite gone, Noah finds courage for coffee, careful to sniff the powdered cream before spooning.
“Two years ago, before Empowerment Centers, sitting meant babysitting suicidal or crazy ER patients committed to a
psych hospital. They might wait days, even weeks, for a psych bed to open. My job was simple: guard them so they don’t
hurt themselves or take off. That’s it. I was paid by the hour to sit, read and sketch in my journal. When they created
Empowerment Centers to decompress the ERs, I was at the right place at the right time. More money plus bennies. It’s a
different place now, and a different job.”
“Every fairy tale has a fairy and a tail,” says Perk, cocking a fiendish brow.
Noah empties sugar packets on the table, fingers designs into the white granules.
“Diego Morales, my first negligent demise, back in the ER days, wasn’t really my fault. I was watching four other psych
patients, way too many. The ER was crazy. A woman was found stone-dead in the corner of the waiting room, not
answering when her name was finally called. In the chaos, Diego bolted. I never saw anyone run so fast in a johnny and
bare feet. The waiting room cheered. A new empty bed. When the ambulance entrance doors opened, Diego turned and
smiled at me chasing him. It was a playful smile, not mean or spiteful. But with his eyes turned he never saw the
ambulance pulling in until it crushed his head.”
Perk slams his hand on the table. “That’s a bad day,” he says. “Lauren and this guy with the hole in his chest, they got
what they wanted. Let’s get loaded and celebrate.”
Noah’s nerves are fried circuits the next morning when Patient 0401, a Swallow and Wallow, steps in for her SST. A
Swallow and Wallow is someone who ingests or allegedly ingests pills, immediately calls for help, then demands to be left
alone. Patient 0401 bathes in the attention from the no-nonsense women surrounding her stretcher: her mother, a
sister, and two clinging preschool children. Noah gives the family a sympathetic nod as he leads her into the room and
locks the door. To have such an army of love behind you must make the world appear small, or at least master-able.
She rolls her eyes, as if pitying Noah and his job. “My boyfriend is coming.”
He points to the sign on the wall. No family. No friends. Especially no boyfriends or girlfriends. “For the next hour it’s you
and…” Noah sweeps his hand to display the numerous suicide options. Explanations aren’t necessary. Her old records
reveal three previous visits, fights with three separate boyfriends, three alleged overdoses.
Patient 0401 is young, narrow-waisted, with suspicious dark eyes and a charcoal-painted mouth. The charcoal was meant
to absorb any pills. She spit it all over the nurses. The ER doctor forced a gastric tube down her throat; equal parts
punishment and treatment. Once medically cleared, she was sent to the Empowerment Center for the SST.
Normally Noah isn’t so vigilant with Swallow and Wallows, but Mr. Curling ruled the gunshot blast to the chest a near-
negligent demise. She put him on warning, told Noah what her boss said: he was holding onto his job by a pubic hair.
He sits behind his desk, follows Patient 0401’s every movement. She appears to shrink while looking around, crushed by
the cruel reality of the place. If you truly desire to end your life, the room must feel like Club Med. But if you don’t, the
mandatory hour in the company of so much opportunity and truth begins to hurt.
Pounding at the door ruptures the silence.
“Hector?” She wails.
“The room is soundproof,” says Noah. “Focus on why you’re here.”
“Says who?” She asks. “You? You’re no shrink. Maybe a shrink-a-dink.”
“How lucky you are,” he says, picturing her worried family outside the door.
Mascara tears run down her cheeks. “You don’t understand me. Nobody does.”
“That’s a lot to ask for.”
“Fuck you,” she says, then settles into the sweet calm typical of most Swallow and Wallows.
The virtues expected from Sitters as listed in the SST manual — trust, sympathy, and patience — are foreign to Noah at
the moment. He sits on his desktop, reminded how Lauren had been a Swallow and Wallow. They had talked as the hour
counted down. She believed Noah possessed a penetrating mind. Noah thought the SST cornered people into insight and
he was simply a lucky bystander. Perhaps Lauren finally realized this herself and left.
Patient 0401 studies his ID badge, crinkles her nose. “Noah?”
She shrugs, shakes her head. “Noah is like a Bible cartoon character. All those animals in a line,” she says. “Adam isn’t
cartoony. Eve isn’t cartoony.”
“Fifty-three minutes and you can go,” Noah says.
She gestures to the room. “Tell me, do you think Noah was a savior, or evil for allowing the rest of the world to drown in
“This is only a job,” he says. “I’m not saving the world.”
“But you’re here to save me, aren’t you?”
Disarmed by her charcoal smile, Noah can’t find an answer.
“You look like that actor, who plays all those crazy people. What’s his name?”
“Steve Buscemi,” says Noah, who shrugs knowingly.
“But you’re better looking.” She offers her hand. “I’m Maria.”
Noah nods, awkwardly holding the complement. They talk about Hector and her children the rest of the hour, not
Genesis. Afterwards, she signs the departure packet: a declaration that she will not hurt herself and will seek help if she
has the urge to do so; a psychiatric referral for the next day; and a coupon for a free large pizza.
Two long days and nights have passed. He no longer believes Lauren will return as inexplicably as she had disappeared.
He calls Lauren’s parents, her sister and best friend. They don’t answer; don’t return his messages.
His head is filled with cement. Sleep pulls but he can’t soften enough to go there. He tries the bed, the couch, even the
floor. When the phone rings, Noah snaps at the phone as if it might fly away. It’s not Lauren. It’s Patient 0401.
“Hector is shit,” she says.
He hears cracks in her voice, silence in unexpected places.
“Why are you calling me?” He asks. “How did you get my number?”
“I thought you cared about me.”
When I’m at work I care,” says Noah. “I’m home now,” he pauses. “With my own problems.”
She hangs up. The caller ID taunts him. Will she do something stupid? He starts dialing, then stops. “She’s a Swallow and
Wallow, right?” Noah reminds himself.
“Forget Lauren. Call up this Maria Wacko and fuck her brains out,” says Perk, pushing his and Noah’s empty beer glasses
towards the bartender, a beauty they’ve nicknamed Corset Girl.
“Seriously, Perk,” Noah says. His brain floats in beer. It feels good unless he needs to think. “I miss Lauren. I want Lauren
“OK. Go get her.”
“I don’t know where she is.”
“Exactly,” says Perk. “Because she doesn’t want to be found. She’s gone.”
“But why? I deserve an explanation.”
“Nah. How long were you two together? Six months? You barely accumulated memories with real nourishment.”
“We bought stuff. Coffee mugs, towels, even bedsheets. We started a life.”
“It was self-preservation. There was no way she was sleeping on your disgusting linen.” Perk pinches tobacco from a
packet, rolls a cigarette. “She thought you sweet, but un-ambitious, an unfortunate part of her charitable phase.” He tells
Corset Girl where to set the beers, as if they aren’t the only people in the bar at 11am. “Focus on Maria. Fuck her kidneys
out. Fuck her until she needs dialysis.”
Corset Girl sweeps her raven hair streaked with hot pink off her shoulder, waits for payment with a stiff brow. Perk tips
her very well. The hatred in her green eyes softens. Her black leather skirt and a tightly laced corset give the impression
of impenetrability. She’s too radiant and serious to be tending bar in a dump, Noah thinks.
She allows Perk to smoke at the bar.
“Such a treat,” says Perk.
“It’s your funeral,” she says.
Perk points to the cigarette in his hand and giggles. “This is harmless. My DNA is carcinogenic. My dad died of lung and
throat cancer. My older brother died of a brain cancer.” Dredging tragedy makes him winded. He catches his breath.
“When I was a kid, our hamsters grew furry tumors. The Habittrail had a hospice unit. Even my dad’s sailboat had a
Cutters slice their skin to kill the pain. Noah thinks Perk uses puns the same way.
Corset Girl is speechless. She restlessly dumps pretzels into shallow bowls.
“My mother died of breast cancer,” she says, staring across the room to the St. Pauli Girl poster above the jukebox as
she manufactures a smile. “I’m not used to mastectomy being a punchline.”
“She needs a hug,” Noah whispers to Perk.
“She needs a good…” Perks says, thrusting his fist piston-like. He finishes the pint in a long effortless gulp.
“Say something to her,” Noah says. “You like her. It’s obvious.”
“Are you serious? You’re giving me advice on women?”
An earth-shifting quiet fills Noah’s one-bedroom apartment that evening. He’s reminded of his parents’ arguments before
they broke up, he and his younger brother listening in the bottom bunk under a tightly drawn blanket. His brother is now
bouncing across Eastern Europe on a Fullbright. His parents each remarried several years ago but still busied themselves
with the old demons: money, alcohol, trust.
Noah can’t get out of his head. The next few sleepless nights creep by never-ending and when mornings come, they’re
muddy and difficult to negotiate. He starts arriving early for work. He cleans and oils the revolver, sharpens the knives,
secures the noose. He focuses on these details as if they’re acts of meditation, only without the calm.
Patient 0430 is muscular and broodingly handsome, the type who appears in bronze light in cologne advertisements. The
paperwork states Patient 0430 swallowed pills after his girlfriend broke up with him. “Another one?” Noah thinks, as
Patient 0430 uses his piercing light blue eyes to burn Noah’s presence into smoke and ash.
“I just oiled the gun,” says Noah, meeting his icy gaze.
Patient 0430 ruffles his black hair, stares hard at the door. Noah has noticed this tendency before, patients hoping to be
rescued by the very people they want to escape.
“The knives are freshly sharpened,” Noah says. Using the anatomical poster on the wall, he traces the path of the jugular
vein and carotid artery.
“You think this is a joke,’ says Patient 0430. “But you know nothing about me.”
“You told people you want to kill yourself,” Noah says. “Why should I stop you?”
Patient 0430 grabs a knife, turns to Noah. “You’re questioning my seriousness?”
“What did you hope to accomplish by taking pills?” Noah says, backpedaling. He knows the blade aimed at him can carve
easily through a Thanksgiving turkey, bones and all, and slice breadcrumbs in the stuffing paper-thin. He knows this, and
yet he can’t shut up as he falls back into his chair. “Will your girlfriend feel bad for you?” He asks Patient 0430. “Will she
now think, ‘On second thought, this person really has hit shit together and perhaps I made a horrible mistake in
judgment? No, she’s going to run as far from you as possible.”
Patient 0430’s knuckles his eyebrow. “Are you stupid, are you thick, or do you have a death wish?” He says.
“The knife concerns me,” says Noah, “But you? Not so much.”
Noah is mindful that the biggest mistake a Sitter can make is downplaying threats. His hand gropes for the panic button
behind the desk. Never before has he needed it, and wonders if it works when no help arrives. Patient 0430 now towers
close. Noah breathes him in, thinks he’s too good looking to stink this bad. Noah concludes that now might be the time
for fear and self-defense, when Patient 0430 grins, spins away, drops to his knees. Noah expects to hear the knife fall.
Instead, the sharp blade glistens under the man’s chin. Noah moves his lips in silent prayer, ashamed by this need for
cheap faith. Losing his life doesn’t frighten him as much as losing his job.
“I can’t know what you’re going through,” says Noah, “but it must be painful.”
Patient 0430 lifts his head for a moment. A critical pause. An opportunity. Noah leaps over the desk, kicks the knife away
and tackles Patient 0430. He imagines this heroic stunt executed with dream-like grace. Saving a life, rescuing someone
from harm, heats his blood. He feels molded perfectly to the world. He even feels a strange kinship with Patient 0430 now.
But Patient O430 is convulsing with laughter.
“What’s so funny?”
“You’re not an athlete, are you?”
Noah finds the knife, pushes it into Patient 0430’s hands. “Use it, or move on.”
Patient 0430’s hums as Noah rushes through the exit packet. He rips the psych referral slip into the tiniest pieces, waves
the pizza coupon as if a winning lottery ticket.
Mrs. Curling calls Noah into her office the next day to discuss Patient 0430’s responses to the online satisfaction survey
— using a 0 to 5 scale — patients rarely fill out.
My emotional needs were honored: 0
I was given the time and space to contemplate this difficult time in my life: 0
Other comments: The next time I feel like killing myself I’m going into the woods with a rifle and blowing my brains all over
the whistling birds and wildflowers. The people at The East Side Empowerment Center don’t deserve the opportunity to
save me. I shared the pizza — which didn’t suck, but wasn’t NY pizza — with my girlfriend and we’re now back together.
May I suggest a soft drink coupon as well?’
“He’s a crackpot,” says Noah. “The worse kind of crackpot. He’s not genuine.”
“The client comes first,” says Mrs. Curling.
“Client? Isn’t he a patient?”
“You’re not a doctor. Neither am I. It doesn’t matter. We provide a valuable service,” she says. “What’s important for us,
right now, is responding to this complaint.”
“If he really wants to off himself, send him a list of isolated woodlands.”
“We don’t want people killing themselves at home. We don’t get reimbursed if that happens.”
“Most of them are manipulators, attention seekers.”
“But we also identify folks with serious mental illness. The SST is about hope and you were glib and disrespectful.”
“This guy was never going to kill himself, or me,” says Noah.
“How do you know?”
“I just do,” he says.
“The hole in Patient 0478’s chest argues otherwise.” An acid-reflux cringe squeezes her face. “Damn it, Noah. Where’s
your head when you need it most?”
“You’re firing me, aren’t you?”
She shuffles papers as if she expects the answer to fall from the sheath.
“I’ll be vested in the 401K in a week. Can’t you wait seven days?”
Noah trudges up the stairs to his third floor apartment. The hallway light flickers with each heavy step. Lauren’s absence
makes his studio feel smaller. The futon couch, the mattress on the floor, the two chairs at the round breakfast table
stare at him, dusty and disappointed. Thinking of Patient 0430 makes him disgusted with himself. He rubs his forehead to
forcibly expel Lauren from his memory. She left him and he’s hurting. Even if she returned now, it would remediate the
leaving but wouldn’t touch the hurt.
Noah calls Perk, leaves a message on his cell. An hour later he calls again. The urgency to talk to someone is unbearable.
What courage it took for Maria to call him, only to be coldly dismissed? Was Patient 0478 expecting something from him
in the milliseconds before the gun popped? Noah wonders what would have happened if only he had asked, “How are you
doing?” A few words might have been enough to allow the trigger urge to speed by. A few fucking words.
Noah walks downtown, hoping to run into a forgotten someone, hoping that something unexpected will happen, which
never does when you’re wishing for it. He studies crowds filling the sidewalks, picks out those who might attempt suicide
and those who might actually succeed — an occupational hazard. Depressives can sense other depressives. His
depression accounts for his success as a Sitter, which is ironic, since a psychiatric history disqualifies impressive
candidates from entering the profession.
Noah visits Corset Girl, asks if she’s seen Perk.
“He’s spared me lately,” she says. She’s wearing jeans, a T-shirt, and no make-up. Without her Gothic corset she looks
vulnerable, like a turtle without a shell.
The bar is empty, though it’s after 11pm and other bars on the strip throb with live music and insane screaming.
“He’s misunderstood,” Noah says, “and he’s a quarter of your clientele.”
“You’re a good friend,” she says with a lopsided smile.
“So is he,” Noah says.
She throws a coaster on the bar. “What can I get you?”
Noah orders a pint. “So you’re an actress-something?” He asks.
“I’m beyond hyphen. I own this pit.” She sips too slowly from a glass beneath the bar. Noah can tell she’s drunk. “This is
my end of the rainbow.”
Noah downs half his beer. He desperately wants to say something kind.
“Do you miss her?” Asks Noah. “Your mom? Do you still miss her as much?”
“Do you really care?” She asks, pursing her lips with suspicion.
“I care enough to ask the question and listen to the answer,” says Noah.
She takes his glass though he’s not finished with his beer. She briefly lifts her head while topping him off. Noah sees a
soft light, a glint of promise in her gaze. Later, she doesn’t ask him to leave when closing. She locks up; cashes out. She
leans heavily on him as they walk to his apartment, presses her head against his shoulder. He swells from the thrill of
holding someone, the confidence found when counted on for support.
Entering his apartment with her, he breathes through her nostrils air that is heavy with stagnation. Before he can
apologize or make excuses, she leaves his arm for the bathroom and runs the shower. He finds an extra towel, puts it to
the sniff test, and knocks on the door. Through the dim light he makes out her shadow behind the shower door. Unsure
if it’s desire or numbness that drives him, Noah sheds his clothes and stands behind her. He tests her bony shoulders,
her butterfly tattoo with its wings drained of vivid colors, as if her skin was rigged like an electric fence. She leans back. He
moves self-consciously, as if they’re actors in a bad porn movie. She gently kisses his lips. Mad groping follows, then she
pulls away and lets out a scream. He freezes, as if now stuck in a bad horror movie. She jumps from the shower,
porcelain skin dripping. She dresses, trips while slipping into her flats, cowers from Noah when he offers his hand.
“What is it? What did I do?” He asks, suddenly sober, still frighteningly aroused. She screams again, flings open the front
door. “I thought you were someone else.”
Someone else? Noah wonders, gulping coffee, popping ibuprofen. He’s wrung out, wrinkled, and hung over. He needs
Ricki Lee Jones at this moment, her first album, or even Pirates, her second, but can’t find either in his CD stacks. Lucinda
Williams is missing. And Tom Waits. John Hiatt, too. Noah can’t believe Lauren would take the music he curls up with
when the black cloud socks in, the friends he looks to for comfort until he finds his way out.
Too washed out for anger, Noah naps until late afternoon, then shrugs down the block to Hugh’s Bruised CDs. He flips
through a mess of loosely arranged stacks. Hoping to stumble upon one replacement, Noah is amazed to find every one
he desperately needs. What are the odds, he wonders. A thin smile lifts the corner of his mouth. Maybe his luck is
changing? He rubs the scratched plastic cases. An unexpected familiarity warms him. He studies each one, then hangs his
head, sick with certainty.
“My ex-girlfriend sold you my CDs without my permission,” he tells Hugh.
“What did you do to make her do something like that?”
“Why is this about me?” Asks Noah. “Can’t she just be insane?”
“It takes two to be crazy,” say Hugh. “At least two.”
“I lost my job. I just want my CDs back.”
Hugh strokes his beard that reaches a belly that Noah hopes is filled with kindness in addition to donuts. Powder streaks
his CBGB T-shirt. Noah haggles a price for two CDs. He’s grateful to return home with bits of his life he didn’t realize were
These tiny reclamations feel like worthy accomplishments. A week goes by, Perk still hasn’t returned his calls. Noah’s
anger shifts to concern when an automated message states his number is out of service. If Perk left town for Harvard
Law, he’d believe it. If they found Perk’s body in the gutter, he’d believe that too. But he’s ashamed by one cruel fact: he
doesn’t know where to look for him. He never visited Perk’s apartment. They always met on neutral ground, shared with
each other only what they cared to reveal. When they said goodbye, Noah assumed Perk stumbled back to a similarly
lousy apartment with sloping floors, a running toilet, a refrigerator filled with condiments, white bread, peanut butter and
whatever beer was on sale at Safeway. Noah realizes he has no choice but to visit Corset Girl. She isn’t a friend, but she’s
“Has Perk shown up?” Noah asks, careful to keep his tone flat.
She shakes her head wearing a big smile. Regardless of who she thought he was a few weeks ago, her eyes sparkle now.
He fixes a long, piercing gaze upon her. She stands nervously. She finally turns away. He can’t figure her out, but thinks
he’s tapped something soulful, fragile, and alluring. She would take her life, if it ever came to that.
“What would you like?” She asks, throwing a coaster on the bar.
“I came for a coaster,” says Noah, brandishing the round disc like an Olympic medal and steps away. Her twisted
expression could be mistaken for pleasure or pain. He stops, approaches the bar again. She crosses and uncrosses her
arms, tugs on the corset, moves haltingly as if conceding a hug, but definitely not a kiss.
She gasps as Noah snaps her in a headlock and pummels her head with nuggies. His knuckle grates against her scalp.
“Are you crazy?” She says, fighting him off.
“How can I be someone else?”
He feels the heat from her nostrils. His touch lightens, until his fingertips comb softly through her thick hair. Her defensive
grip on his wrist relaxes. Noah can’t tell if she’s pushing him away, or guiding him. This intimate confusion lasts only for
an instant, when, from behind the bar, she wields a short steel pipe, grip padded with tape. “Don’t you know I can kick
“You didn’t,” he says.
She raises her head, face flushed. “You came back.” Her lower lips quivers.
Noah kisses her forehead and floats out the bar.
Noah sleeps hard that night. He wakes into a lighter body and spongier world. He visits the Empowerment Center to
speak with Mrs. Curling. “I heard there were two negligent demises this week. Give me another chance?”
She stares off as if fighting a distant glare. “This job isn’t good for you,” she says.
Her raised hand staunches his attempts at denial.
“I know about your depression,” she says.
“That’s nuts,” he says.
“I knew from the moment I met you.”
It isn’t the depth of the depression, but the open recognition of it that makes him as weak as he’s ever felt.
“We can’t protect people from themselves. People with serious problems don’t start whistling and skipping after a psych
visit and a free pizza.”
“We’re weeding out the low risk folks.”
“Some people are supposed to succeed, right? Why else should the knives be sharpened, the gun cleaned and oiled? Let’
s be honest, here. Bad outcomes are expected.”
Mrs. Curling looks away. “We provide choices.” She clears her throat. “I’m worried about you, Noah. Why would you want
this job back?”
“It anchors me. Without it, I’m afraid I’ll disappear.”
Noah begs Hugh again to return his CDs. “Sorry, dude,” says Hugh. “I’ve got two cats to feed.” He agrees to remove
them from the racks so only Noah can buy them. Noah reacquires the first Tracy Chapman CD. Noah thinks he’d feel
resentful or frustrated doling out money for things that were rightfully his and stolen away. But he cherishes them anew,
more than if they were simply pulled off the shelves covered with dust.
Noah can’t find work. Rejection feels like a blow to the back of the head. If not for the treks to the CD shop, he has little
reason to dress and step outside.
Late one morning, still in bed, Noah dreams that Mrs. Curling lures him back with a huge signing bonus. His first patient,
Patient 0508, stuns him with joy. Perk doesn’t say hello. He’s thin, feral, and stares ravenously at the sacks of pills, the
noose, the knives, the shooting booth. Perk cases the room in oversized wingtips. Standing in the middle of traffic, he
reportedly said he was waiting for a vehicle with good karma to hit him.
“Where have you been?” Noah asks. “I’ve left tons of messages on your cell.”
“Incommunicado,” Park says, as if it’s a hedonistic island off South America.
“You don’t just disappear like that.”
“Aren’t we free to do as we please if it doesn’t interfere with the freedom others?” Noah notices he hasn’t looked back at
the closed door.
“Didn’t you think that you might be missed?”
“It’s always about you, isn’t it?”
“I thought you might want to talk,” says Noah. “Really talk.”
“Then what?” Perk laughs sadly. “Eventually the talking stops.”
Perk coughs, then sighs and mouths the gun barrel.
“Stop it,” yells Noah. “Do you really want to die?”
Perk removes the barrel. Their eyes lock. “I’m tired of distracting myself.”
Noah springs up from bed, drenched in sweat, shivering. He calls Perk’s cell — still out of order. Craving a cup of coffee,
he crumbles at the lightness and sound of a package with only a spoonful of grinds. A storm of tears, violent and fast-
moving, carves through his body. When it’s done, he’s left exhausted, emptied, but also repleted. He looks around. The
mid-day sun bleaching his bedroom window is the only witness. He changes into a dry T-shirt that he picks off the floor.
Slowly, as if pacing himself, he collects scattered laundry, rips the sheets from his bed, and even dumps out a few bureau
drawers. He stuffs it all into two pillowcases, enough dead weight to pull him off-balance when first flung over his
shoulders, and marches to the Coin-O-Matic.